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Villeneuve T, Hermant C, Le Borgne A, Murris M, Plat G, Héluain V, Colombat M, Courtade-Saïdi M, Evrard S, Collot S, Salaün M, Guibert N. Real-time and non-invasive acute lung rejection diagnosis using confocal LASER Endomicroscopy in lung transplant recipients: Results from the CELTICS study. Pulmonology 2024:S2531-0437(24)00014-X. [PMID: 38402125 DOI: 10.1016/j.pulmoe.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Traditionally, the diagnosis of acute rejection (AR) relies on invasive transbronchial biopsies (TBBs) to obtain histopathological samples. We aimed to evaluate the diagnostic yield of probe-based confocal laser endomicroscopy (pCLE) as a complementary and non-invasive tool for ACR screening, comparing its results with those obtained from TBBs. METHODS Between January 2015 and April 2022, we conducted a retrospective study of all lung transplant recipients aged over 18 years at Toulouse University Hospital (France). All patients who underwent bronchoscopies with both TBBs and pCLE imaging were included. Two experienced interpreters (TV and MS) reviewed the pCLE images independently, blinded to all clinical information and pathology results. RESULTS From 120 procedures in 85 patients, 34 abnormal histological samples were identified. Probe-based confocal laser endomicroscopy revealed significant associations between both alveolar (ALC) and perivascular (PVC) cellularities and abnormal histological samples (p<0.0001 and 0.003 respectively). Alveolar cellularity demonstrated a sensitivity (Se) of 85.3 %, specificity (Spe) of 43 %, positive predictive value (PPV) of 37.2 % and negative predictive value (NPV) of 88.1 %. For PVC, Se was 70.6 %, Spe 80.2 %, PPV 58.5 % and NPV 87.3 %. Intra-interpreter correlation (TV) was 88.3 % for the number of vessels (+/-1), 98.3 % for ALC and 90 % for PVC. Inter-interpreter correlation (TV and MS) was 80 % for vessels (+/-1), 97.5 % for ALC and 83.3 % for PVC. CONCLUSION Our study demonstrates the feasibility of incorporating pCLE into clinical practice, demonstrating good diagnostic yield and reproducible outcomes in the screening of AR in lung transplant recipients.
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Affiliation(s)
- T Villeneuve
- Respiratory Medicine Department, Toulouse University Hospital, Toulouse, France.
| | - C Hermant
- Respiratory Medicine Department, Toulouse University Hospital, Toulouse, France
| | - A Le Borgne
- Respiratory Medicine Department, Toulouse University Hospital, Toulouse, France
| | - M Murris
- Respiratory Medicine Department, Toulouse University Hospital, Toulouse, France
| | - G Plat
- Respiratory Medicine Department, Toulouse University Hospital, Toulouse, France
| | - V Héluain
- Respiratory Medicine Department, Toulouse University Hospital, Toulouse, France
| | - M Colombat
- Cytology and Pathology Department, University Cancer Institute, Toulouse, France
| | - M Courtade-Saïdi
- Cytology and Pathology Department, University Cancer Institute, Toulouse, France
| | - S Evrard
- Cytology and Pathology Department, University Cancer Institute, Toulouse, France
| | - S Collot
- Radiology Department, Toulouse University Hospital, Toulouse, France
| | - M Salaün
- Respiratory Medicine Department, Department, Rouen University Hospital, Toulouse, France
| | - N Guibert
- Respiratory Medicine Department, Toulouse University Hospital, Toulouse, France
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de Ville de Goyet M, Kicinski M, Suciu S, Vandecruys E, Uyttebroeck A, Ferster A, Freycon C, Plat G, Thomas C, Barbati M, Dresse MF, Paillard C, Pluchart C, Simon P, Chantrain C, Minckes O, van der Werff Ten Bosch J, Bertrand Y, Rohrlich P, Millot F, Paulus R, Benoit Y, Piette C. Long-term neurotoxicity among childhood acute lymphoblastic leukaemia survivors enrolled between 1971 and 1998 in EORTC Children Leukemia Group studies. Discov Oncol 2024; 15:20. [PMID: 38285235 PMCID: PMC10825101 DOI: 10.1007/s12672-024-00869-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/19/2024] [Indexed: 01/30/2024] Open
Abstract
Survival after childhood acute lymphoblastic leukemia (ALL) has increased over the last 40 years with an overall survival above 90%. Survivors may experience neurological late effects secondary to chemotherapy and radiotherapy. This observational retrospective study evaluated the cumulative incidence of neurological late effects among 890 childhood ALL survivors treated in EORTC CLG trials (58741, 58831/2 and 58881) between 1971 and 1998. Median follow-up was 19 years and interquartile range of the follow-up was 15-22 years. At 20 years from the end of treatment, approximately 66% of patients from the 58741 trial (accrual time: 1971-1978) and approximately 15% from the more recent trials had cognitive disturbance grade 1 or higher. Cumulative incidences at 20 years from treatment end of seizures, stroke and leukoencephalopathy were respectively 45%, 16% and 62% in study 58741, 13%, 2% and 5% in study 58831/2, and 8%, 2% and 3% in study 58881. Patients who were 10-17 years of age at diagnosis had a higher incidence of stroke and leukoencephalopathy as compared to those less than 6 years of age. Noteworthy, all neurological late effects continued to occur beyond 5 years after end of treatment. This retrospective study highlights the frequency of neurological late effects in survivors of childhood ALL. With the increase of the overall survival of ALL patients, the role and potential benefit of longitudinal neurological screening should be evaluated in further studies as these neurological late effects become an important public health challenge. This study is part of the larger EORTC CLG 58 Late Adverse Effects (LAE) study (ClinicalTrials.gov Identifier NCT01298388, date of registration February 16, 2011).
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Affiliation(s)
- Maëlle de Ville de Goyet
- Department of Paediatric Haematology-Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | | | | | - Els Vandecruys
- Department of Paediatric Haematology-Oncology, Ghent University Hospital, Ghent, Belgium
| | - Anne Uyttebroeck
- Department of Paediatric Haematology-Oncology, University Hospital Leuven, Louvain, Belgium
| | - Alina Ferster
- Department of Haemato Oncology, HUDERF (ULB), Brussels, Belgium
| | - Claire Freycon
- Department of Paediatric Haematology-Oncology, CHU Grenoble, Grenoble, France
| | - Geneviève Plat
- Department of Haematology, CHU Toulouse, Toulouse, France
| | | | - Mélissa Barbati
- Department of Paediatric Haematology-Oncology, CHRU Lille, Lille, France
| | - Marie-Françoise Dresse
- Department of Paediatrics, University Hospital Liège and University of Liège, Liège, Belgium
| | - Catherine Paillard
- Department of Paediatric Haematology-Oncology, CHRU Strasbourg, Strasbourg, France
| | - Claire Pluchart
- Department of Paediatric Haematology and Oncology, CHU Reims, Reims, France
| | | | | | - Odile Minckes
- Department of Paediatric Haematology-Oncology, CHU Caen, Caen, France
| | | | - Yves Bertrand
- Department of Paediatric Onco-Haematology, Lyon University Hospital, Hospices Civils de Lyon and, Université Claude Bernard Lyon, Lyon, France
| | - Pierre Rohrlich
- Division of Paediatric Haematology-Oncology, CHU Nice, Nice, France
| | - Frederic Millot
- Department of Paediatric Haematology-Oncology, CHU Poitiers, Poitiers, France
| | | | - Yves Benoit
- Department of Paediatric Haematology-Oncology, Ghent University Hospital, Ghent, Belgium
| | - Caroline Piette
- Department of Paediatrics, University Hospital Liège and University of Liège, Liège, Belgium.
- Service de Pédiatrie, CHU Liège, Avenue de l'Hôpital 1, 4000 Liège, Belgium.
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Kicinski M, Arfeuille C, Grardel N, Bakkus M, Caye-Eude A, Plat G, Ferster A, Uyttebroeck A, De Moerloose B, Rohrlich P, Suciu S, Bertrand Y, Cavé H. The prognostic value of IKZF1 plus in B-cell progenitor acute lymphoblastic leukemia: Results from the EORTC 58951 trial. Pediatr Blood Cancer 2023; 70:e30313. [PMID: 36971444 DOI: 10.1002/pbc.30313] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/07/2023] [Accepted: 03/03/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND IKZF1 gene deletion is an indicator of poor prognosis in childhood B-cell precursor acute lymphoblastic leukemia (BCP-ALL). The AEIOP/BFM group proposed that the prognostic strength of IKZF1 deletion could be remarkably improved by taking into account additional genetic deletions and reported that among patients with an IKZF1 deletion those with deletions in CDKN2A/2B, PAX5, or PAR1 in the absence of ERG deletion, grouped as IKZF1plus , had the worst outcome. PROCEDURE Between 1998 and 2008, 1636 patients under 18 years of age with previously untreated BCP-ALL were registered in the EORTC 58951 trial. Those with multiplex ligation-dependent probe amplification data were included in this analysis. Unadjusted and adjusted Cox model was used to investigate the additional prognostic value of IKZF1plus . RESULTS Among 1200 patients included in the analysis, 1039 (87%) had no IKZF1 deletion (IKZF1WT ), 87 (7%) had an IKZF1 deletion but not IKZF1plus (IKZF1del ) and 74 (6%) had IKZF1plus . In the unadjusted analysis, both patients with IKZF1del (hazard ratio [HR] = 2.10, 95% confidence interval [CI]: 1.34-3.31) and IKZF1plus (HR = 3.07, 95% CI: 2.01-4.67) had a shorter event-free survival compared with IKZF1WT . However, although the IKZF1plus status was associated with patients' characteristics indicating poor prognosis, the difference between IKZF1plus and IKZF1del was not statistically significant (HR = 1.46, 95% CI: 0.83-2.57, p = .19). The results of the adjusted analysis were similar to the unadjusted analysis. CONCLUSIONS In patients with BCP-ALL from the EORTC 58951 trial, the improvement of the prognostic importance of IKZF1 by considering IKZF1plus was not statistically significant.
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Affiliation(s)
| | - Chloé Arfeuille
- Département de Génétique, Hôpital Robert Debré, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
- INSERM, UMR_S1131, Institut de Recherche Saint-Louis, Université Paris-Cité, Paris, France
| | | | - Marleen Bakkus
- Laboratory of Molecular Haematology, University Hospital Brussels, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Aurélie Caye-Eude
- Département de Génétique, Hôpital Robert Debré, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
- INSERM, UMR_S1131, Institut de Recherche Saint-Louis, Université Paris-Cité, Paris, France
| | - Geneviève Plat
- Department of Hematology, CHU Toulouse, Toulouse, France
| | - Alina Ferster
- Department of Hemato-Oncology, HUDERF (ULB), Brussels, Belgium
| | - Anne Uyttebroeck
- Department of Pediatric Hemato-Oncology, University Hospital Leuven, Leuven, Belgium
| | - Barbara De Moerloose
- Department of Pediatric Hematology-Oncology, Ghent University Hospital, Ghent, Belgium
| | | | | | - Yves Bertrand
- Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Université Lyon, Lyon, France
| | - Hélène Cavé
- Département de Génétique, Hôpital Robert Debré, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
- INSERM, UMR_S1131, Institut de Recherche Saint-Louis, Université Paris-Cité, Paris, France
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Faust C, Auquier P, Bertrand Y, Tabone MD, Ansoborlo S, Baruchel A, Gandemer V, Dalle JH, Chastagner P, Kanold J, Poirée M, Theron A, Plat G, Pellier I, Michel G, Berbis J. Impact of childhood leukemia on siblings: their long-term perception of family functioning and its relationship with their psychosocial characteristics using structural equation modeling. J Cancer Surviv 2023:10.1007/s11764-023-01385-2. [PMID: 37162684 DOI: 10.1007/s11764-023-01385-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/14/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE In the context of pediatric cancer, siblings' adaptation and needs have been previously investigated; however, research on the long-term consequences on siblings, especially on their family environment, is scarce. We aimed to (1) assess the family functioning (FF) perceived by siblings of childhood leukemia survivors long after diagnosis and (2) explore characteristics likely associated and investigate associations with psycho-behavioral and social factors. METHODS Childhood leukemia survivors' siblings older than 11 years were recruited through the LEA cohort, a French long-term follow-up program, and completed the family assessment device (FAD). Logistic regression analysis was used to determine factors likely associated with unhealthy functioning in families as perceived by siblings. Structural equation modeling (SEM) was used to examine relationships that predict siblings' perception of FF. RESULTS We included 605 siblings (mean follow-up time from diagnosis 14.1 ± 6.8 years), of whom 175 (28.9%) perceived unhealthy functioning. SEM showed that older siblings were more likely to perceive problematic functioning (β = 0.095, p = 0.014). Sex and leukemia burden had indirect effects on FF through mediators. Family financial situation at diagnosis was not associated with the risk of reporting unhealthy functioning. CONCLUSIONS Our study contributed to identifying siblings at risk of facing family issues and reinforced the need to provide more consideration and suitable resources to avoid late consequences. Often considered as the "forgotten children", future research should focus on developing targeted interventions to facilitate family communication and improve siblings' social support. IMPLICATIONS FOR CANCER SURVIVORS Overall, results regarding FF perceived by siblings are reassuring and provide new enlightening elements that allow for better support to all families.
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Affiliation(s)
- Cindy Faust
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France.
| | - Pascal Auquier
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
| | - Yves Bertrand
- Department of Pediatric Hematology-Oncology, University Hospital of Lyon, Lyon, France
| | - Marie-Dominique Tabone
- Department of Pediatric Hematology-Oncology, A. Trousseau Hospital, AP-HP, Paris, France
| | - Sophie Ansoborlo
- Department of Pediatric Hematology-Oncology, University Hospital of Bordeaux, Bordeaux, France
| | - André Baruchel
- Department of Pediatric Hematology-Oncology, Saint Louis Hospital, AP-HP, Paris, France
| | - Virginie Gandemer
- Department of Pediatric Hematology-Oncology, University Hospital of Rennes, Rennes, France
| | - Jean-Hugues Dalle
- Department of Pediatric Hematology, Robert Debré Hospital, AP-HP, Paris, France
| | - Pascal Chastagner
- Department of Pediatric Hematology-Oncology, Children's Hospital of Brabois, Vandoeuvre Les Nancy, France
| | - Justyna Kanold
- Department of Pediatric Hematology-Oncology, University Hospital of Clermont-Ferrand, CIC Inserm 501, Clermont-Ferrand, France
| | - Maryline Poirée
- Department of Pediatric Hematology-Oncology, University Hospital of Nice, Nice, France
| | - Alexandre Theron
- Department of Pediatric Hematology-Oncology, University Hospital of Montpellier, Montpellier, France
| | - Geneviève Plat
- Department of Pediatric Hematology-Oncology, University Hospital of Toulouse, Toulouse, France
| | - Isabelle Pellier
- Department of Pediatric Hematology-Oncology, University Hospital of Angers, Angers, France
| | - Gérard Michel
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
- Department of Pediatric Hematology-Oncology, Timone Children's Hospital and Aix-Marseille University, Marseille, France
| | - Julie Berbis
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
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5
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Faust C, Auquier P, Hamidou Z, Bertrand Y, Tabone MD, Ansoborlo S, Baruchel A, Gandemer V, Dalle JH, Chastagner P, Kanold J, Poirée M, Sirvent N, Plat G, Pellier I, Michel G, Berbis J. Brothers and sisters of childhood acute leukemia survivors: Their long-term quality of life and its determinants. Cancer Med 2023; 12:6200-6212. [PMID: 36266927 PMCID: PMC10028038 DOI: 10.1002/cam4.5355] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/13/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Childhood cancer confront the whole family with a traumatic event. Because brothers and sisters may encounter emotional problems that can remain for a long time and that only few studies have assessed their long-term outcome, our present objectives were to describe the long-term quality of life (QoL) of childhood leukemia survivors' siblings and to explore its determinant. METHODS Brothers and sisters (from 8-year-old) of survivors included in the French LEA Cohort completed a QoL questionnaire (according to their age). Scores were compared with those reported by age- and gender-matched French general population and by survivors. Using a clustering method, siblings were categorized into 3 groups depending on their level of QoL's scores and factors likely to be linked with these clusters were explored with multivariate analyses. RESULTS We included 689 brothers and sisters (313 minors, 376 adults) and the mean time from diagnosis was 13.2 ± 6.6 years. Minor siblings reported higher QoL scores than general population (p < 0.001), but a lower score for relationship with family than survivors (p < 0.001). In adult siblings, Mental Component Summary score was lower than general population (p < 0.001). Level of siblings' QoL was linked with female gender, but no association was found with cancer-related factors. CONCLUSION Brothers and sisters expressed a divergent perception of their long-term QoL depending on their age. To minimize the impact from childhood to adulthood, long-term attention should also be paid to siblings, often referred as "forgotten children".
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Affiliation(s)
- Cindy Faust
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
| | - Pascal Auquier
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
| | - Zeinab Hamidou
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
| | - Yves Bertrand
- Department of Pediatric Hematology-Oncology, University Hospital of Lyon, Lyon, France
| | - Marie-Dominique Tabone
- Department of Pediatric Hematology-Oncology, A. Trousseau Hospital, AP-HP, Paris, France
| | - Sophie Ansoborlo
- Department of Pediatric Hematology-Oncology, University Hospital of Bordeaux, Bordeaux, France
| | - André Baruchel
- Department of Pediatric Hematology-Oncology, Saint Louis Hospital, AP-HP, Paris, France
| | - Virginie Gandemer
- Department of Pediatric Hematology-Oncology, University Hospital of Rennes, Rennes, France
| | - Jean-Hugues Dalle
- Department of Pediatric Hematology, Robert Debré Hospital, AP-HP, Paris, France
| | - Pascal Chastagner
- Department of Pediatric Hematology-Oncology, Children's Hospital of Brabois, Vandoeuvre Les Nancy, France
| | - Justyna Kanold
- Department of Pediatric Hematology-Oncology, CIC Inserm 501, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Maryline Poirée
- Department of Pediatric Hematology-Oncology, University Hospital L'Archet, Nice, France
| | - Nicolas Sirvent
- Department of Pediatric Hematology-Oncology, University Hospital of Montpellier, Montpellier, France
| | - Geneviève Plat
- Department of Pediatric Hematology-Oncology, University Hospital of Toulouse, Toulouse, France
| | - Isabelle Pellier
- Department of Pediatric Hematology-Oncology, University Hospital of Angers, Angers, France
| | - Gérard Michel
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
- Department of Pediatric Hematology-Oncology, Timone Children's Hospital and Aix-Marseille University, Marseille, France
| | - Julie Berbis
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
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Chabut M, Schneider P, Courbiere B, Saultier P, Bertrand Y, Tabone MD, Pochon C, Ducassou S, Paillard C, Gandemer V, Kanold J, Dalle JH, Poiree M, Plat G, Thouvenin S, Plantaz D, Sirvent N, Weinhard S, Berbis J, Baruchel A, Leverger G, Hamidou Z, Auquier P, Michel G. Ovarian Function and Spontaneous Pregnancy After Hematopoietic Stem Cell Transplantation for Leukemia Before Puberty: An L.E.A. Cohort Study. Transplant Cell Ther 2023:S2666-6367(23)01130-2. [PMID: 36849077 DOI: 10.1016/j.jtct.2023.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 02/27/2023]
Abstract
Ovarian function impairment and infertility are among the most frequent late effects after hematopoietic stem cell transplantation (HSCT). The aim of this study was to evaluate ovarian function, occurrence of premature ovarian insufficiency (POI), and spontaneous pregnancy in a large cohort of adult survivor women who had undergone HSCT for leukemia before puberty. We conducted a retrospective observational study in women from the national cohort L.E.A., the long-term French follow-up program after childhood leukemia. The median follow-up duration was 18 years (14.2-23.3) after HSCT. Among 178 women, 106 (60%) needed pubertal induction with hormone substitution treatment, whereas 72 (40%) had spontaneous menarche. After spontaneous menarche, 33 (46%) developed POI, mostly within 5 years of HSCT. Older age at time of HSCT and cryopreservation of ovarian tissue appeared as significant risk factors for POI. More than 65% of patients who underwent HSCT before the age of 4.8 years had spontaneous menarche, and almost 50% didn't have POI at last evaluation, whereas more than 85% with HSCT after the age of 10.9 years didn't have spontaneous menarche and needed induction of puberty with hormone replacement therapy. Twenty-two women (12%) had at least one spontaneous pregnancy, with 17 live-births, 14 miscarriages, 4 legal abortions, and 2 therapeutic abortions. These results add supplementary data to better counsel patients and their families on the chances of ovarian residual function and pregnancy after HSCT, as well as on the potential interest of fertility preservation.
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Affiliation(s)
- Mathilde Chabut
- Department of Pediatrics, University Hospital of Rouen, Rouen, France.
| | - Pascale Schneider
- Department of Pediatric Hematology and Oncology, University Hospital of Rouen, Rouen, France
| | - Blandine Courbiere
- Department of Gynecology-Obstetric and Reproductive Medicine, AP-HM, Hôpital La Conception/Aix-Marseille Université, IMBE, CNRS, IRD, Avignon Université, Marseille, France
| | - Paul Saultier
- Department of Pediatric Hematology, Immunology and Oncology, APHM, La Timone Children's Hospital, Marseille, France; Aix Marseille Univ, INSERM, INRAe, C2VN, Marseille, France
| | - Yves Bertrand
- Department of Pediatric Hematology and Oncology, University Hospital of Lyon, Lyon, France
| | - Marie-Dominique Tabone
- Department of Pediatric Hematology and Oncology, Armand Trousseau Hospital, AP-HP, Sorbonne University, Paris, France
| | - Cécile Pochon
- Department of Pediatric Hematology and Oncology, Children's Hospital of Brabois, Brabois,France
| | - Stéphane Ducassou
- Department of Pediatric Hematology and Oncology, University Hospital of Bordeaux, Bordeaux, France
| | - Catherine Paillard
- Department of Pediatric Hematology-Oncology, University Hospital, Strasbourg, France
| | - Virginie Gandemer
- Department of Pediatric Hematology and Oncology, University Hospital of Rennes, Rennes, France
| | - Justyna Kanold
- Department of Pediatric Hematology and Oncology, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Jean-Hugues Dalle
- Department of Pediatric Onco-Hematology, University Hospital of Saint Louis, Paris, France; Department of Hematology and immunology, Hôpital Robert-Debré, GHU APHP-Nord Université de Paris-Cité, Paris, France
| | - Maryline Poiree
- Department of Pediatric Hematology and Oncology, University Hospital L'Archet, Nice, France
| | - Geneviève Plat
- Department of Pediatric Hematology and Oncology, University Hospital of Toulouse, Toulouse, France
| | - Sandrine Thouvenin
- Department of Pediatric Onco-hematology, CHU de Saint-Etienne, Saint-Etienne, France
| | - Dominique Plantaz
- Department of Pediatric Hematology and Oncology, University Hospital of Grenoble, Grenoble, France
| | - Nicolas Sirvent
- Department of Pediatric Hematology and Oncology, University Hospital of Montpellier, Montpellier, France
| | - Sara Weinhard
- Department of Pediatric Hematology and Oncology, Children's Hospital of Brabois, Brabois,France
| | - Julie Berbis
- CEReS Research Unit EA 3279 and Department of Public Health, Hôpital de la Timone, Marseille, France
| | - André Baruchel
- Department of Hematology and immunology, Hôpital Robert-Debré, GHU APHP-Nord Université de Paris-Cité, Paris, France
| | - Guy Leverger
- Department of Pediatric Hematology and Oncology, Armand Trousseau Hospital, AP-HP, Sorbonne University, Paris, France
| | - Zeinab Hamidou
- CEReS Research Unit EA 3279 and Department of Public Health, Hôpital de la Timone, Marseille, France
| | - Pascal Auquier
- CEReS Research Unit EA 3279 and Department of Public Health, Hôpital de la Timone, Marseille, France
| | - Gérard Michel
- Department of Pediatric Hematology, Immunology and Oncology, APHM, La Timone Children's Hospital, Marseille, France; CEReS Research Unit EA 3279 and Department of Public Health, Hôpital de la Timone, Marseille, France
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7
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Huault A, Michel G, Charon V, Chouklati K, Domenech C, Chastagner P, Dalle JH, Paillard C, Ducassou S, Poirée M, Plat G, Tabone MD, Kanold J, Baruchel A, Berger C, Pellier I, Plantaz D, Theron A, Mustafa A, Auquier P, Gandemer V. Symptomatic osteonecrosis in French survivors of childhood and adolescent leukemia: a clinical and MRI study of LEA cohort. Pediatr Hematol Oncol 2023:1-17. [PMID: 36820621 DOI: 10.1080/08880018.2023.2168810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Osteonecrosis (ON) is a known complication of acute leukemia (AL) management, affecting 1%-10% of young patients and resulting in long-term morbidity. Widespread access to MRI over the past decade has allowed earlier detection and more accurate assessment. This study investigated clinical and MRI features of the 129 (2.5%) patients with symptomatic ON retrospectively recruited from the French LEA (Leucémies de l'Enfant et de l'Adolescent, or child and adolescent leukemias) cohort (n = 4,973). We analyzed data concerning ON risk factors, multifocal involvement, severe lesions detected by MRI, and patient quality of life (QoL). ON patients tended to be >10 years old at the time of AL diagnosis (odds ratio [OR]: 22.46; p < 10-6), female (OR: 1.8; p = 0.002), or treated for relapse (OR: 1.81; p = 0.041). They more frequently suffered from other sequelae (p < 10-6). Most necroses involved weight-bearing joints, and they were multifocal in 69% of cases. Double-blinded review of MRIs for 39 patients identified severe lesions in 14, usually in the hips. QoL of adolescents and adults was poor and permanently impacted after onset of ON. In conclusion, age >10 at time of AL diagnosis, female sex, and relapse occurrence were risk factors for multifocal ON; MRI revealed severe ON in a third of the patients considered; and ON was associated with persistently poor QoL affecting multiple domains. Future studies should include prospective data addressing ON management and seek to identify genetic markers for targeted screening enabling early ON detection and treatment.
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Affiliation(s)
- Alice Huault
- Department of Pediatric Hematology-Oncology, Nantes University Hospital, Nantes, France
| | - Gérard Michel
- Department of Pediatric Oncology, Aix-Marseille University and La Timone Children's Hospital, Marseille, France
| | - Valérie Charon
- Department of Radiology, Rennes University Hospital, Rennes, France
| | - Kamal Chouklati
- Department of Radiology, Rennes University Hospital, Rennes, France
| | - Carine Domenech
- Department of Pediatric Hematology-Oncology, Pediatric Hematology and Oncology Institute (IHOPE), Hospices Civils de Lyon, University Lyon 1, Lyon, France
| | - Pascal Chastagner
- Department of Pediatric Hematology-Oncology, Hôpital d'Enfants de Brabois, Vandoeuvre-lès-Nancy, France
| | - Jean-Hugues Dalle
- Department of Pediatric Hematology, Robert Debré Hospital, Paris, France
| | - Catherine Paillard
- Department of Pediatric Hematology-Oncology, Strasbourg University Hospital, Strasbourg, France
| | - Stéphane Ducassou
- Department of Pediatric Hematology-Oncology, Bordeaux University Hospital, Bordeaux, France
| | - Marilyne Poirée
- Department of Pediatric Hematology-Oncology, Nice University Hospital (L'Archet), Nice, France
| | - Geneviève Plat
- Department of Pediatric Hematology-Oncology, Toulouse University Hospital (Purpan), Toulouse, France
| | - Marie-Dominique Tabone
- Department of Pediatric Hematology-Oncology, Armand Trousseau Hospital, APHP. Sorbonne Université, Paris, France
| | - Justyna Kanold
- Department of Pediatric Hematology-Oncology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - André Baruchel
- Department of Pediatric Hematology, Robert Debré Hospital, Paris, France
| | - Claire Berger
- Department of Pediatric Hematology, Saint-Étienne University Hospital, Saint-Etienne, France
| | | | - Dominique Plantaz
- Department of Pediatric Hematology-Oncology, Grenoble Alpes University Hospital, Grenoble, France
| | - Alexandre Theron
- Department of Pediatric Hematology-Oncology, Montpellier University Hospital, Montpellier, France
| | - Alaa Mustafa
- Department of Public Health, EA 3279 Research Unit, Marseille University Hospital, Aix-Marseille University, Marseille, France
| | - Pascal Auquier
- Department of Public Health, EA 3279 Research Unit, Marseille University Hospital, Aix-Marseille University, Marseille, France
| | - Virginie Gandemer
- Department of Pediatric Hematology and Oncology department, University Hospital, Rennes, France
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8
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Courbiere B, Drikes B, Grob A, Hamidou Z, Saultier P, Bertrand Y, Gandemer V, Plantaz D, Plat G, Poirée M, Ducassou S, Pochon C, Dalle JH, Thouvenin S, Paillard C, Kanold J, Sirvent A, Rousset-Jablonski C, Duros S, Gueniffey A, Cohade C, Boukaidi S, Frantz S, Agopiantz M, Poirot C, Genod A, Pirrello O, Gremeau AS, Bringer-Deutsch S, Auquier P, Michel G. The uterine volume is dramatically decreased after hematopoietic stem cell transplantation during childhood regardless of the conditioning regimen. Fertil Steril 2023; 119:663-672. [PMID: 36627013 DOI: 10.1016/j.fertnstert.2022.12.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 12/22/2022] [Accepted: 12/28/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To study the impact of hematopoietic stem cell transplantation (HSCT) on the uterine volume of childhood acute leukemia (AL) survivor depending on age at HSCT and the type of myeloablative conditioning regimen. SETTING Thirteen French University Teaching Hospitals. DESIGN Prospective cohort study. PATIENT(S) Eighty-eight women who underwent HSCT during childhood or adolescence for AL compared to a control group. INTERVENTION(S) A multicentric prospective national study compared the uterine volume in a cohort of childhood AL survivor adult women treated with HSCT, matched 1:1 to control women. Pelvic magnetic resonance imaging scans included diffusion-weighted imaging sequences. Scans were centralized for a double-blinded reading by 2 radiologists. MAIN OUTCOME MEASURE(S) Uterine volume, uterine body-to-cervix ratio, and apparent diffusion coefficient. RESULT(S) The mean age at HSCT was 9.1 ± 0.3 years with a mean follow-up duration of 16.4 ± 0.5 years. The cohort of 88 HSCT survivor women was composed of 2 subgroups depending on the myeloablative conditioning regimen received: an alkylating agent-based regimen group (n = 34) and a total body irradiation (TBI)-based regimen group (n = 54). Among the 88 women, 77 were considered as having a "correct hormonal balance" with estrogens supplied by hormone replacement therapy (HRT) for premature ovarian insufficiency (POI) or because of a residual ovarian function. In the control group (n = 88), the mean uterine volume was 79.7 ± 3.3 mL. The uterine volume significantly decreased in all HSCT survivor women. After the alkylating agent-based regimen, the uterine volume was 45.3 ± 5.6 mL, corresponding to a significant volume reduction of 43.1% (28.8-57.4%) compared with that of the control group. After TBI, the uterine volume was 19.6 ± 1.9 mL, corresponding to a significant volume reduction of 75.3% (70.5%-80.2%) compared with that of the control group. After the alkylating agent-based regimen, the uterine volume dramatically decreased in women with POI without HRT compared with that in those with a correct hormonal balance (15.2 ± 2.6 vs. 49.3 ± 6 mL). In contrast, after TBI, the uterine volume was similar in all women, with no positive effect of hormonal impregnation on the uterine volume (16.3 ± 2.6 vs. 20.1 ± 2.2 mL, respectively). CONCLUSION(S) The uterine volume was diminished after HSCT, regardless of the conditioning regimen. The physiopathology needs to be further investigated: specific impact of a high dose of an alkylating agent; impact of hormone deprivation around puberty; poor compliance to HRT; or different myometrial impact of HRT compared with endogenous ovarian estrogens? CLINICAL TRIAL REGISTRATION NUMBER ClinicalTrials.gov/NCT03583294 (enrollment of the first subject, November 11, 2017; enrollment of the last subject, June 25, 2021).
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Affiliation(s)
- Blandine Courbiere
- Department of Gynecology-Obstetric and Reproductive Medicine, AP-HM, Hôpital La Conception/Aix-Marseille Université, IMBE, CNRS, IRD, Avignon Université, Marseille, France.
| | - Benjamin Drikes
- Department of Radiology, University Teaching Hospital Timone, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France
| | - Anaïs Grob
- Department of Radiology, University Teaching Hospital Timone, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France
| | - Zeinab Hamidou
- CEReS Research Unit EA 3279 and Department of Public Health, Hôpital de la Timone, Marseille, France
| | - Paul Saultier
- Department of Pediatric Hematology, Immunology and Oncology, AP-HM, La Timone Children's Hospital, Marseille, France; Aix Marseille Univ, INSERM, INRAe, C2VN, Marseille, France
| | - Yves Bertrand
- Department of Pediatric Hematology and Oncology, University Hospital of Lyon, Lyon, France
| | - Virginie Gandemer
- Department of Pediatric Hematology and Oncology, University Hospital of Rennes, Rennes, France
| | - Dominique Plantaz
- Department of Pediatric Hematology-Oncology, University Hospital of Grenoble, Grenoble, France
| | - Geneviève Plat
- Department of Pediatric Hematology and Oncology, University Hospital of Toulouse, Toulouse, France
| | - Maryline Poirée
- Department of Pediatric Hematology and Oncology, University Hospital L'Archet, Nice, France
| | - Stéphane Ducassou
- Department of Pediatric Hematology and Oncology, University Hospital of Bordeaux, Bordeaux, France
| | - Cécile Pochon
- Department of Pediatric Hematology and Oncology, Children's Hospital of Brabois, Vandoeuvre-Les-Nancy, France
| | - Jean-Hugues Dalle
- Department of Hematology and immunology, Hôpital Robert-Debré, GHU APHP-Nord Université de Paris-Cité, Paris, France
| | - Sandrine Thouvenin
- Department of Pediatric Onco-hematology, CHU de Saint-Etienne, Saint-Etienne, France
| | - Catherine Paillard
- Department of Pediatric Hematology-Oncology, University Hospital, Strasbourg, France
| | - Justyna Kanold
- Department of Pediatric Hematology and Oncology, CIC Inserm 501, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Anne Sirvent
- Department of Pediatric Onco-Hematology, University Hospital of Montpellier, Montpellier, France
| | - Christine Rousset-Jablonski
- Département de Chirurgie Oncologique, Centre Léon Bérard, Lyon, France, and Hospices Civils de Lyon, Département de Gynécologie-Obstétrique, Groupe Hospitalier Sud, Pierre Benite Cedex, France; INSERM U1290 RESHAPE RESearch in HealthcAre PErformance, Université Lyon 1, Lyon, France
| | - Solène Duros
- Département de Gynécologie-Obstétrique et Reproduction Humaine, CHU Rennes, Rennes, France
| | - Aurore Gueniffey
- Centre Hospitalier Universitaire de Grenoble, Hôpital Couple-Enfant, Centre Clinique et Biologique d'Assistance Médicale à la Procréation- Centre d'étude et de conservation des œufs et du sperme humains (CECOS), La Tronche, France
| | - Clementine Cohade
- Department of Reproductive Medicine, Toulouse University Hospital, Toulouse, France
| | - Samir Boukaidi
- Department of Obstetrics and Gynecology and Reproductive Medicine, CHU de Nice, Archet 2 Hospital, Nice, France
| | - Sandrine Frantz
- Service de Chirurgie Gynécologique et Médecine de la reproduction, Centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, Bordeaux cedex, France
| | - Mikael Agopiantz
- Department of Reproductive Medicine, CHRU de Nancy, Université de Lorraine, Nancy, France INSERM U1256, Université de Lorraine, Vandœuvre-lès-Nancy, France
| | - Catherine Poirot
- Department of Hematology, AYA Unit, Saint Louis Hospital, Paris, France, Médecine Sorbonne Université, Site Pitié Salpêtrière, Paris, France, and Department of Reproductive Biology, Cochin Hospital AP-HP, Paris, France
| | - Anne Genod
- Service de Gynécologie-Obstétrique, Université Jean-Monnet, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - Olivier Pirrello
- Assisted Reproductive Technique Unit, CMCO, University Hospital of Strasbourg, Schiltigheim, France
| | - Anne-Sophie Gremeau
- Department of Gynecologic Surgery and IVF, Clermont-Ferrand, University Hospital Clermont-Ferrand, Clermont-Ferrand, France
| | - Sophie Bringer-Deutsch
- Service de Gynécologie-Obstétrique et Médecine de la reproduction, CHU Arnaud-de-Villeneuve, Montpellier, France
| | - Pascal Auquier
- CEReS Research Unit EA 3279 and Department of Public Health, Hôpital de la Timone, Marseille, France
| | - Gérard Michel
- CEReS Research Unit EA 3279 and Department of Public Health, Hôpital de la Timone, Marseille, France; Department of Pediatric Hematology, Immunology and Oncology, AP-HM, La Timone Children's Hospital, Marseille, France
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9
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Héluain V, Dutau H, Plat G, Brindel A, Guibert N. [Bronchoscopic management of malignant central airway obstructions]. Rev Mal Respir 2023; 40:94-100. [PMID: 36577607 DOI: 10.1016/j.rmr.2022.11.084] [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: 07/27/2022] [Accepted: 11/29/2022] [Indexed: 12/27/2022]
Abstract
Up to 30% of lung cancer patients suffer from central airway obstruction, resulting in major deterioration in prognosis and quality of life. Interventional bronchoscopy combines a number of invasive techniques used during rigid bronchoscopy. It is designed to rapidly improve symptoms, primarily dyspnea. Applied according to very precise indications, this technique requires careful patient selection and needs to be incorporated into the multimodal oncological management in combination with systemic treatments, radiation therapy and surgery.
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Affiliation(s)
- V Héluain
- Unité d'endoscopie thoracique, service de pneumologie, hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - H Dutau
- Service d'oncologie thoracique, maladies de la plèvre et pneumologie interventionnelle, hôpital Nord, Marseille, France
| | - G Plat
- Unité d'endoscopie thoracique, service de pneumologie, hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - A Brindel
- Unité d'endoscopie thoracique, service de pneumologie, hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - N Guibert
- Unité d'endoscopie thoracique, service de pneumologie, hôpital Larrey, CHU de Toulouse, Toulouse, France.
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10
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Barbati M, Kicinski M, Suciu S, Mazingue F, Vandecruys E, Plat G, Uyttebroeck A, Paillard C, Dresse M, Simon P, Pluchart C, Minckes O, Ferster A, Freycon C, Millot F, Van Der Werff ten Bosch J, Chantrain C, Paulus R, de Schaetzen G, Rossi G, Rohrlich P, Benoit Y, Piette C. Socio-economic outcomes among long-term childhood acute lymphoblastic leukaemia survivors enrolled between 1971 and 1998 in EORTC CLG studies: Results of the 58LAE study. Eur J Cancer Care (Engl) 2022; 31:e13755. [PMID: 36284405 PMCID: PMC9787328 DOI: 10.1111/ecc.13755] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/09/2022] [Accepted: 10/09/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The objective of this study is to evaluate the socio-economic outcomes of survivors of childhood acute lymphoblastic leukaemia (ALL). METHODS Childhood ALL adult survivors, enrolled in EORTC trials between 1971 and 1998 in France and Belgium, were invited to fill out a questionnaire with information about their socio-economic situation (living with a partner, having a university degree, having a job, working part time and history of having a paid job). The outcomes were compared with two matched control populations. RESULTS Among 1418 eligible patients, 507 (35.8%) participated, including 39 (8%) and 61 (12%) patients who received a haematopoietic stem cell transplantation (HSCT) and a cranial radiotherapy (CRT), respectively. The median time to follow-up was 20 years, and median age was 25 years. Survivors showed a socio-economic level at least as good as controls. HCST and CRT were associated with a higher probability of not obtaining a bachelor degree (respectively OR = 3.49, 95% CI: 1.46-8.35 and OR = 2.31, 95% CI: 1.04-5.15), HSCT was associated with unemployment (OR = 2.89, 95% CI: 1.09-7.65) and having a relapse was associated with a higher probability of not having a partner (OR = 1.88, 95% CI: 1.01-3.51) adjusting for confounders. CONCLUSION Childhood ALL survivors showed a high level of socio-economic participation. HCST and CRT were associated with poorer functioning.
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Affiliation(s)
- Melissa Barbati
- Department of Pediatric Hematology‐OncologyCHRU LilleLilleFrance
| | | | - Stefan Suciu
- Statistics DepartmentEORTC HeadquartersBrusselsBelgium
| | | | - Els Vandecruys
- Department of Pediatric Hematology‐OncologyGhent University HospitalGhentBelgium
| | | | - Anne Uyttebroeck
- Department of Pediatric Hemato‐OncologyUniversity Hospital LeuvenLeuvenBelgium
| | - Catherine Paillard
- Department of Pediatric Hematology‐OncologyCHRU StrasbourgStrasbourgFrance
| | | | | | - Claire Pluchart
- Department of Pediatric Haematology and OncologyCHU ReimsReimsFrance
| | - Odile Minckes
- Department of Pediatric Hematology‐OncologyCHU CaenCaenFrance
| | - Alina Ferster
- Department of Hemato‐OncologyHUDERF (ULB)BrusselsBelgium
| | - Claire Freycon
- Department of Pediatric Hematology‐OncologyCHU GrenobleGrenobleFrance
| | - Frederic Millot
- Department of Pediatric Hematology‐OncologyCHU PoitiersPoitiersFrance
| | | | | | | | | | - Giovanna Rossi
- Medical DepartmentEORTC HeadquartersBrusselsBelgium,Present address:
R&D DepartmentBreast International Group (BIG)BrusselsBelgium
| | | | - Yves Benoit
- Department of Pediatric Hematology‐OncologyGhent University HospitalGhentBelgium
| | - Caroline Piette
- Department of PaediatricsUniversity Hospital Liège and University of LiègeLiègeBelgium
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11
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Courbière B, Drikes B, Gros A, Hamidou Z, Bertrand Y, Gandemer V, Poiree M, Plantaz D, Plat G, Contet A, Ansoborlo S, Paillard C, Kanold J, Auquier P, Michel G. O-267 Uterine volume is dramatically decreased in Stem Cell Hematopoietic Transplantation childhood survivors whatever the conditioning regimen. A case-control MRI study in the L.E.A cohort. Hum Reprod 2022. [DOI: 10.1093/humrep/deac106.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What is the impact of the type of myeloablative conditioning (MAC) regimen applied for hematopoietic stem cell transplantation (HSCT) on uterine volume of childhood leukemia survivors?
Summary answer
Uterine volume is significantly decreased after HSCT. Not only Total Body Irradiation (TBI), but also high-dose chemotherapy-based regimens containing alkylating agents induce uterine damage.
What is known already
Premature ovarian failure after HSCT is well known, as well as the uterine damage induced by TBI on uterine volume. A few studies have reported smaller uterus after HSCT in women treated with chemotherapy only. In these studies, uterus volume was assessed by a transabdominal and/or transvaginal ultrasonography, and primary diagnosis, age at treatment and chemotherapy regimen were heterogeneous. These preliminary results suggested that alkylating agents could induce uterine damage, as well as they induce fibrosis and vascular damage in ovarian stroma. The impact of chemotherapy on myometrium and uterus is still few investigated.
Study design, size, duration
A prospective multicentric national study was conducted between 2017, November and 2021, June in 16 University Teaching Hospitals that are following more than 4 500 childhood acute leukemia survivors enrolled in the L.E.A cohort. We included 88 adult women treated for a childhood acute leukemia with HSCT and who agreed a pelvic MRI assessment. Every case was matched 1:1 to control women who underwent MRI for benign ovarian cysts or benign pelvic pathology.
Participants/materials, setting, methods
Pelvic MRI scans were performed with a 1.5-T or 3T magnetic resonance scanner, including diffusion-weighted imaging sequences. Scans were centralized for a double-blinded lecture by two radiologists. The main outcome was the uterine volume. The secondary outcomes were uterine body-to-cervix ratio and apparent diffusion coefficient (ADC). Univariate and multivariate analyses have investigated the association of clinical and imaging variables with conditioning regimen and age at HSCT.
Main results and the role of chance
The mean age in HSCT group was 26.5 + 6.3 years. Mean age at HSCT was 9.1 + 0.3 years with a mean follow-up of 16.4 + 0.5 years. Among the 88 women included in HSCT group, two groups of conditioning regimens have been compared to the control group: a chemotherapy-only MAC regimen group with high dose of alkylating agents (n = 34) and one TBI-based regimen group (n = 52). Two MRI scans were not available. Among HSCT group, 75 women were considered as “normally impregnated” by estrogens, by hormone replacement therapy (HRT) for premature ovarian insufficiency (POI) or thanks to a residual ovarian function. Uterine volume was significantly decreased both after chemotherapy-only MAC regimen and after TBI, with respectively 45.3 + 5.6 and 19.6 + 1.9 mL Vs 79.7 + 3.3 mL in control population (p < 0.01). In chemotherapy-only MAC regimen group, uterine volume was dramatically decreased in POI women without HRT compared to those having a hormonal impregnation (15.2 + 2.6 Vs 49.3 + 6 mL, p < 0.05). In contrast, after TBI, uterine volume was similar in all women, with no positive effect of HRT on uterine volume (respectively 16.3 + 2.6 Vs 20.1 + 2.2 mL).
Limitations, reasons for caution
The number of pregnancies obtained spontaneously or after oocyte donation in our study population was too low to evaluate the obstetrical impact of uterine damage caused by non-TBI regimens.
Wider implications of the findings
Our results provide strong evidence that a MAC regimen containing high dose of alkylating agents could induce uterine damage. In these sub-group of women, HRT increases the volume of the uterus compared to non-treated women. After TBI, uterine volume is dramatically decreased, with no benefit of HRT on it.
Trial registration number
NCT 03583294
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Affiliation(s)
- B Courbière
- AP-HM Hôpital de la Conception / Aix Marseille University, gynecology-obstetrics and reproductive medicine , Marseille, France
| | - B Drikes
- AP-HM Hôpital de La Timone , Radiology, Marseille, France
| | - A Gros
- AP-HM Hôpital de La Timone , Radiology, Marseille, France
| | - Z Hamidou
- Hôpital de la Timone, CEReS Research Unit EA 3279- , Marseille, France
- Departmentof Public Health 3279- , Marseille, France
| | - Y Bertrand
- University Hospital of Lyon , Pediatric hematology , Lyon, France
| | - V Gandemer
- University Hospital of Rennes, Pediatric Hematology and Oncology , Rennes, France
| | - M Poiree
- University Hospital L'Archet , Pediatric Hematology and oncology , Nice, France
| | - D Plantaz
- University Hospital of Grenoble, Pediatric Hematology and Oncology , Grenoble, France
| | - G Plat
- University Hospital of Toulouse, Pediatric Hematology and Oncology , Toulouse, France
| | - A Contet
- Children's Hospital of Brabois , Pediatric Hematology and Oncology , Vandoeuvre-les-Nancy, France
| | - S Ansoborlo
- University Hospital of Bordeaux, Pediatric Hematology and Oncology , Bordeaux, France
| | - C Paillard
- University Hospital of Strasbourg, Pediatric Hematology and Oncology , Strasbourg, France
| | - J Kanold
- University Hospital of Clermont-Ferrand , Pediatric hematology and Oncology , Clermont-Ferrand, France
| | - P Auquier
- APHM Hôpital de la Timone / Aix Marseille University, CEReS Research Unit EA 3279 and Department of Public Health , Marseille, France
| | - G Michel
- La Timone Children's Hospital, Pediatric Hematology- Immunology and Oncology , Marseille, France
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12
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Delebarre M, Gonzales F, Behal H, Tiphaine A, Sudour-Bonnange H, Lutun A, Abbou S, Pertuisel S, Thouvenin-Doulet S, Pellier I, Mansuy L, Piguet C, Paillard C, Blanc L, Thebaud E, Plantaz D, Blouin P, Schneider P, Guillaumat C, Simon P, Domenech C, Pacquement H, Le Meignen M, Pluchart C, Vérite C, Plat G, Martinot A, Duhamel A, Dubos F. Decision-tree derivation and external validation of a new clinical decision rule (DISCERN-FN) to predict the risk of severe infection during febrile neutropenia in children treated for cancer. Lancet Child Adolesc Health 2022; 6:260-268. [PMID: 34871572 DOI: 10.1016/s2352-4642(21)00337-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/11/2021] [Accepted: 10/18/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND In 2017, international guidelines proposed new management of febrile neutropenia in children with cancer, adapted to the risk of severe infection by clinical decision rules (CDRs). Until now, none of the proposed CDRs has performed well enough in high-income countries for use in clinical practice. Our study aimed to build and validate a new CDR (DISCERN-FN) to predict the risk of severe infection in children with febrile neutropenia. METHODS We did two prospective studies. First, a prospective derivation study included all episodes of febrile neutropenia in children (aged <18 years) with a cancer diagnosis and receiving treatment for it who were admitted for an episode of febrile neutropenia, excluding patients already treated with antibiotics for this episode, febrile neutropenia not induced by chemotherapy, those receiving palliative care, and those with a stem cell allograft for less than 1 year, from April 1, 2007, to Dec 31, 2011 from two paediatric cancer centres in France. We collected the children's medical history, and clinical and laboratory data, and analysed their associations with severe infection. Sipina software was used to derive the CDR as a decision tree. Second, a prospective, national, external validation study was done in 23 centres from Jan 1, 2012, to May 31, 2016. The primary outcome was severe infection, defined by bacteraemia, a positive bacterial culture from a usually sterile site, a local infection with a high potential for extension, or an invasive fungal infection. The CDR was applied a posteriori to all episodes to evaluate its sensitivity, specificity, and negative likelihood ratio. FINDINGS The derivation set included 539 febrile neutropenia episodes (270 episodes in patients with blood cancer [median age 7·5 years, IQR 3·7-11·2; 158 (59 %) boys and 112 (41%) girls] and 269 in patients with solid tumours [median age 6·6 years, IQR 2·9-14·2; 140 (52 %) boys and 129 (48%) girls]). Significant variables introduced into the decision tree were cancer type (solid tumour vs blood cancer), age, high-risk chemotherapy, level of fever, C-reactive protein concentration (at 24-48 h after admission), and leucocyte and platelet counts and procalcitonin (at admission and at 24-48 h after admission). For the derivation set, the CDR sensitivity was 98% (95% CI 93-100), its specificity 56% (51-61), and the negative likelihood ratio 0·04 (0·01-0·15). 1806 febrile neutropenia episodes were analysed in the validation set (mean age 8·1 years [SD 4·8], 1014 (56%) boys and 792 (44%) girls), of which 332 (18%, 95% CI 17-20) were linked with severe infection. For the validation set, the CDR had a sensitivity of 95% (95% CI 91-97), a specificity of 38% (36-41), and a negative likelihood ratio of 0·13 (0·08-0·21). Our CDR reduced the risk of severe infection to a post-test probability of 0·8% (95% CI 0·2-2·9) in the derivation set and 2·4% (1·5-3·9) in the validation set. The validation study is registered at ClinicalTrials.gov, NCT03434795. INTERPRETATION The use of our CDR substantially reduced the risk of severe infection after testing in both the derivation and validation groups, which suggests that this CDR would improve clinical practice enough to be introduced in appropriate settings. FUNDING Ligue Nationale Contre le Cancer.
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Affiliation(s)
- Mathilde Delebarre
- ULR 2694-METRICS: Évaluation des technologies de santé et des pratiques médicales, Université de Lille, Lille, France; Paediatric Emergency Unit & Infectious Diseases, Lille, France; Paediatric Haematology Unit, CHU Lille, Lille, France
| | | | - Hélène Behal
- ULR 2694-METRICS: Évaluation des technologies de santé et des pratiques médicales, Université de Lille, Lille, France
| | - Aude Tiphaine
- Paediatric Emergency Unit & Infectious Diseases, Lille, France
| | | | - Anne Lutun
- Paediatric Haematology-Oncology Unit, CHU Amiens, Amiens, France
| | - Samuel Abbou
- Paediatric Oncology Unit, Gustave-Roussy Institute, Villejuif, France
| | - Sophie Pertuisel
- Paediatric Haematology-Oncology Unit, CHU Rennes, Rennes, France
| | | | - Isabelle Pellier
- Paediatric Haematology-Oncology Unit, CHU Angers, Angers, France
| | - Ludovic Mansuy
- Paediatric Haematology-Oncology Unit, CHU Nancy, Nancy, France
| | | | - Catherine Paillard
- Paediatric Haematology-Oncology Unit, CHU Strasbourg, Strasbourg, France
| | - Laurence Blanc
- Paediatric Haematology-Oncology Unit, CHU Poitiers, Poitiers, France
| | - Estelle Thebaud
- Paediatric Haematology-Oncology Unit, CHU Nantes, Nantes, France
| | - Dominique Plantaz
- Paediatric Haematology-Oncology Unit, CHU Grenoble, Grenoble, France
| | - Pascale Blouin
- Paediatric Haematology-Oncology Unit, CHU Tours, Tours, France
| | | | - Cécile Guillaumat
- Department of Paediatrics, Centre Hospitalier Sud Francilien, Corbeil-Essonne, France
| | - Pauline Simon
- Paediatric Haematology-Oncology Unit, CHU Besançon, Besançon, France
| | - Carine Domenech
- Institute of Paediatric Haematology and Oncology, Hospices Civils de Lyon, University-Lyon, Lyon, France
| | | | | | - Claire Pluchart
- Paediatric Haematology-Oncology Unit, Institut Jean Godinot, CHU Reims, Reims, France
| | - Cécile Vérite
- Paediatric Haematology-Oncology Unit, CHU Bordeaux, Bordeaux, France
| | - Geneviève Plat
- Paediatric Haematology-Oncology Unit, CHU Toulouse, Toulouse, France
| | - Alain Martinot
- ULR 2694-METRICS: Évaluation des technologies de santé et des pratiques médicales, Université de Lille, Lille, France; Paediatric Emergency Unit & Infectious Diseases, Lille, France
| | - Alain Duhamel
- ULR 2694-METRICS: Évaluation des technologies de santé et des pratiques médicales, Université de Lille, Lille, France
| | - François Dubos
- ULR 2694-METRICS: Évaluation des technologies de santé et des pratiques médicales, Université de Lille, Lille, France; Paediatric Emergency Unit & Infectious Diseases, Lille, France.
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13
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Guibert N, Héluain V, Brindel A, Plat G, Dutau H. Prothèses des voies aériennes : état de l’art. Rev Mal Respir 2022; 39:477-485. [DOI: 10.1016/j.rmr.2022.02.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/13/2022] [Indexed: 12/17/2022]
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14
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Ajrouche R, Chandab G, Petit A, Strullu M, Nelken B, Plat G, Michel G, Domenech C, Clavel J, Bonaventure A. Allergies, genetic polymorphisms of Th2 interleukins, and childhood acute lymphoblastic leukemia: The ESTELLE study. Pediatr Blood Cancer 2022; 69:e29402. [PMID: 34662484 DOI: 10.1002/pbc.29402] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 08/12/2021] [Accepted: 09/16/2021] [Indexed: 11/07/2022]
Abstract
CONTEXT A negative association between a history of allergy and childhood acute lymphoblastic leukemia (ALL) has been reported in previous studies, but remains debated. This work aimed to investigate this association accounting for genetic polymorphisms of the Th2 pathway cytokines (IL4, IL10, IL13, and IL4R). METHODS Analyses were based on the French case-control study ESTELLE (2010-2011). The complete sample included 629 ALL cases and 1421 population-based controls frequency-matched on age and gender. The child's medical history was collected through standardized maternal interview. Biological samples were collected, and genotyping data were available for 411 cases and 704 controls of European origin. Odds ratios (OR) were estimated using unconditional regression models adjusted for potential confounders. RESULTS In the complete sample, a significant inverse association was observed between ALL and reported history of allergic rhinitis or sinusitis (OR = 0.65 [0.42-0.98]; P = 0.04), but there was no obvious association with allergies overall. There was an interaction between genetic polymorphisms in IL4 and IL4R (Pinteraction = 0.003), as well as a gene-environment interaction between IL4R-rs1801275 and a reported history of asthma (IOR = 0.23; Pint = 0.008) and eczema (IOR = 0.47; Pint = 0.06). We observed no interaction with the candidate polymorphisms in IL4 and IL13. CONCLUSION These results suggest that the association between allergic symptoms and childhood ALL could be modified by IL4R-rs1801275, and that this variant could also interact with a functional variant in IL4 gene. Although they warrant confirmation, these results could help understand the pathological mechanisms under the reported inverse association between allergy and childhood ALL.
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Affiliation(s)
- Roula Ajrouche
- CRESS, Université de Paris INSERM, UMR 1153, Epidemiology of Childhood and Adolescent Cancers Team, Villejuif, France.,Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
| | - Ghinaj Chandab
- CRESS, Université de Paris INSERM, UMR 1153, Epidemiology of Childhood and Adolescent Cancers Team, Villejuif, France.,Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
| | - Arnaud Petit
- Sorbonne Université, UMRS_938, AP-HP, Hôpital Armand Trousseau, Paris, France
| | | | | | | | | | - Carine Domenech
- Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Université Lyon 1, Lyon, France
| | - Jacqueline Clavel
- CRESS, Université de Paris INSERM, UMR 1153, Epidemiology of Childhood and Adolescent Cancers Team, Villejuif, France.,National Registry of Childhood Cancers, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP) Hôpital Paul Brousse, Villejuif, France and CHU de Nancy, Vandoeuvre-lès-Nancy, Nancy, France
| | - Audrey Bonaventure
- CRESS, Université de Paris INSERM, UMR 1153, Epidemiology of Childhood and Adolescent Cancers Team, Villejuif, France
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15
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Aubert L, Petit A, Bertrand Y, Ray-Lunven AF, Angoso M, Pluchart C, Millot F, Saultier P, Cheikh N, Pellier I, Plantaz D, Sirvent A, Thouvenin-Doublet S, Valduga J, Plat G, Rialland F, Henry C, Esvan M, Gandemer V. Therapeutic approach and outcome of children with Philadelphia chromosome-positive acute lymphoblastic leukemia at first relapse in the era of tyrosine kinase inhibitors: An SFCE retrospective study. Pediatr Blood Cancer 2022; 69:e29441. [PMID: 34854546 DOI: 10.1002/pbc.29441] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/23/2021] [Accepted: 10/16/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Since the introduction of tyrosine kinase inhibitors (TKIs), the profile of pediatric relapse of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) has changed. However, the management of pediatric Ph+ ALL relapses is not currently standardized. PROCEDURE We retrospectively analyzed the therapeutic strategies and outcomes of pediatric Ph+ ALL patients in first relapse who were initially treated with a TKI-containing regimen in one of the French pediatric hematology centers from 2004 to 2019. RESULTS Twenty-seven children experienced a Ph+ ALL relapse: 24 (89%) had an overt relapse and three a molecular relapse. Eight involved the central nervous system. A second complete remission (CR2) was obtained for 26 patients (96%). Induction consisted of nonintensive chemotherapy for 13 patients (48%) and intensive chemotherapy for 14 (52%). Thirteen patients (48%) received consolidation. Allogenic hematopoietic stem cell transplantation (alloHSCT) was performed for 21 patients (78%). The TKI was changed for 23 patients (88%), mainly with dasatinib (n = 15). T315I was the most common mutation at relapse (4/7). The 4-year event-free survival and survival rates were 60.9% and 76.1%, respectively. Survival was positively associated with alloHSCT in CR2. CONCLUSION We show that pediatric first-relapse Ph+ ALL reinduces well with a second course of TKI exposure, despite the use of different therapeutic approaches. The main prognostic factor for survival was alloHSCT in CR2. Because of the small size of the cohort, we could not draw any conclusions about the respective impact of TKIs, but the predominance of the T315I mutation should encourage careful consideration of the TKI choice.
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Affiliation(s)
- Lucie Aubert
- Department of Pediatric Hemato-Oncology, University Hospital of Rennes, Rennes, France
| | - Arnaud Petit
- Pediatric Hematology and Oncology Department, Armand Trousseau Hospital, APHP, Paris, France
| | - Yves Bertrand
- Department of the Institute of Pediatric Hematology and Oncology, University Hospital of Lyon, Lyon, France
| | | | - Marie Angoso
- Pediatric Hematology Oncology Department, University Hospital of Bordeaux, Bordeaux, France
| | - Claire Pluchart
- Department of Pediatric Onco-Hematology, University Hospital of Reims, Reims, France
| | - Frédéric Millot
- Department of Hematological Oncology and Cell Therapy, University Hospital of Poitiers, Poitiers, France
| | - Paul Saultier
- Pediatric Hematology and Oncology Department, La Timone Children's Hospital, AP-HM, Marseille, France
| | - Nathalie Cheikh
- Pediatric Hematology Oncology Unity, University Hospital of Besançon, Besançon, France
| | - Isabelle Pellier
- Pediatric Hematology and Oncology Immunology Department, University Hospital of Angers, Angers, France
| | - Dominique Plantaz
- Pediatric Immuno-Hemato-Oncology Department, University Hospital of Grenoble, Grenoble, France
| | - Anne Sirvent
- Department of Pediatric Onco-Hematology, University Hospital of Montpellier, Montpellier, France
| | | | - Julie Valduga
- Pediatric Oncology and Hematology Department, University Hospital of Nancy (CHRU Nancy), Nancy, France
| | - Geneviève Plat
- Department of Pediatric Hemato-Oncology, University Hospital of Toulouse, Toulouse, France
| | - Fanny Rialland
- Department of Pediatric Onco-Hematology, University Hospital of Nantes, Nantes, France
| | - Catherine Henry
- Cytogenetic and Cell Biology Department, University Hospital of Rennes, Rennes, France
| | - Maxime Esvan
- Rennes University, University Hospital of Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), Rennes, France
| | - Virginie Gandemer
- Department of Pediatric Hemato-Oncology, University Hospital of Rennes, Rennes, France
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16
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Rossi G, Kicinski M, Suciu S, Vandecruys E, Plat G, Uyttebroeck A, Paillard C, Barbati M, Dresse MF, Simon P, Minckes O, Pluchart C, Ferster A, Freycon C, Millot F, van der Werff Ten Bosch J, Chantrain C, Paulus R, de Rojas T, de Schaetzen G, Rohrlich P, Benoit Y, Piette C. Fertility status among long-term childhood acute lymphoblastic leukaemia survivors enrolled between 1971 and 1998 in EORTC CLG studies: results of the 58 Late Adverse Effects study. Hum Reprod 2021; 37:44-53. [PMID: 34788455 DOI: 10.1093/humrep/deab236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/30/2021] [Indexed: 12/31/2022] Open
Abstract
STUDY QUESTION What are the fertility outcomes of male and female childhood acute lymphoblastic leukaemia (ALL) long-term survivors? SUMMARY ANSWER We observed similar fertility outcomes in both male and female childhood ALL survivors compared with the general population, with the exception of a higher proportion of miscarriages among partners of male survivors. WHAT IS KNOWN ALREADY Survival after childhood ALL is currently >90% and fertility impairments are among the main concerns of the long-term survivors. Few studies have focused on the fertility issues within this selected population and the existing data are difficult to interpret due to the different treatment regimens received by the patients, the small sample sizes and the unavailability of control data in many studies. STUDY DESIGN, SIZE, DURATION Childhood ALL patients enrolled in European Organisation for Research and Treatment of Cancer (EORTC) studies between 1971 and 1998 in France and Belgium, <18 years old at diagnosis and alive and ≥18 years at follow-up were eligible. Among 1418 eligible survivors, 507 (35.8%) participated (277 females, 230 males). Controls from the general population matched one to one by age, province, level of urbanization and sex could be identified for 503 survivors. PARTICIPANTS/MATERIALS, SETTING, METHODS Survivors and controls were invited to fill out a questionnaire including information about their menstrual cycles (for females), intention to have children, having children, use of medical help to become pregnant and occurrence of negative pregnancy outcomes (birth defect, miscarriage, medical abortion or stillbirth). The results were analysed separately for females and males. The association between age at diagnosis and fertility outcomes, adjusted by age at follow-up, study and country were investigated using logistic regression. MAIN RESULTS AND THE ROLE OF CHANCE The median time since diagnosis was 20.1 years and the median age at follow-up was 25 years. There were 144 survivors (97 females, 47 males) who wanted to have children. Among these, craniospinal radiotheraphy (CRT) and haematopoietic stem cell transplantation (HSCT) were administered to 18% and 4%, respectively. Of these who tried to have children, 75% of females and 69% of males succeeded, compared with 72% and 61% of the controls, respectively. These differences were not statistically significant (P = 0.73 for females and P = 0.50 for males). Overall, fertility outcomes were comparable between survivors and controls, except that a higher proportion of miscarriages occurred in partners of male survivors (28.1% versus 5.9%, P = 0.021). Among female survivors, an older age at diagnosis (10-17 years) was associated with a greater risk of pregnancy problems (adjusted OR 5.61, P = 0.046). LIMITATIONS, REASONS FOR CAUTION The interpretation of the incidence of miscarriage among the partners of male survivors is limited by the lack of data regarding the males' partners and by a possibly higher tendency to recall and disclose fertility issues among male survivors compared with male controls. WIDER IMPLICATIONS OF THE FINDINGS Fertility outcomes were similar in childhood ALL survivors and controls, and the low proportion of patients treated with CRT or HSCT might explain this. Further studies should confirm the higher proportion of miscarriages in partners of male survivors. STUDY FUNDING/COMPETING INTEREST(S) This publication was supported by donations from the Fonds Cancer (FOCA) from Belgium and the KU Leuven from Belgium. G.R. has been awarded a fellowship by the EORTC Cancer Research Fund (ECRF). C.P. has been awarded a fellowship by Fonds Cancer (FOCA) from Belgium and the Kinderkankerfonds from Belgium (a non-profit childhood cancer foundation under Belgian law). No competing interests were declared. TRIAL REGISTRATION NUMBER NCT01298388 (clinicaltrials.gov).
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Affiliation(s)
- Giovanna Rossi
- Medical Department, EORTC Headquarters, Brussels, Belgium
| | - Michal Kicinski
- Statistics Department, EORTC Headquarters, Brussels, Belgium
| | - Stefan Suciu
- Statistics Department, EORTC Headquarters, Brussels, Belgium
| | - Els Vandecruys
- Department of Paediatric Haematology-Oncology, Ghent University Hospital, Ghent, Belgium
| | - Geneviève Plat
- Department of Haematology, CHU Toulouse, Toulouse, France
| | - Anne Uyttebroeck
- Department of Paediatric Haematology-Oncology, University Hospital Leuven, Leuven, Belgium
| | - Catherine Paillard
- Department of Paediatric Haematology-Oncology, CHRU Strasbourg, Strasbourg, France
| | - Mélissa Barbati
- Department of Paediatric Haematology-Oncology, CHRU Lille, Lille, France
| | | | | | - Odile Minckes
- Department of Paediatric Haematology-Oncology, CHU Caen, Caen, France
| | - Claire Pluchart
- Department of Paediatric Haematology and Oncology, CHU Reims, Reims, France
| | - Alina Ferster
- Department of Haemato Oncology, HUDERF (ULB), Brussels, Belgium
| | - Claire Freycon
- Department of Paediatric Haematology-Oncology, CHU Grenoble, Grenoble, France
| | - Frederic Millot
- Department of Paediatric Haematology-Oncology, CHU Poitiers, Poitiers, France
| | | | | | | | - Teresa de Rojas
- Pediatric OncoGenomics & Innovation Unit, Pediatric Oncology-Hematology Department, Children's University Hospital Niño Jesús, Madrid, Spain
| | | | - Pierre Rohrlich
- Division of Paediatric Haematology-Oncology, CHU Nice, Nice, France
| | - Yves Benoit
- Department of Paediatric Haematology-Oncology, Ghent University Hospital, Ghent, Belgium
| | - Caroline Piette
- Department of Paediatrics, University Hospital Liège and University of Liège, Belgium
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17
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Millot F, Suttorp M, Ragot S, Leverger G, Dalle JH, Thomas C, Cheikh N, Nelken B, Poirée M, Plat G, Versluys B, Lausen B, Borisevich M. Discontinuation of Imatinib in Children with Chronic Myeloid Leukemia: A Study from the International Registry of Childhood CML. Cancers (Basel) 2021; 13:4102. [PMID: 34439257 PMCID: PMC8392145 DOI: 10.3390/cancers13164102] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/06/2021] [Accepted: 08/10/2021] [Indexed: 11/16/2022] Open
Abstract
Within the International Registry of Childhood Chronic Myeloid Leukemia (CML), we identified 18 patients less than 18 years old at diagnosis of CML who were in the chronic phase and exhibiting a sustained deep molecular response (DMR) to imatinib defined as BCR-ABL1/ABL1 < 0.01% (MR4) for at least two years followed by discontinuation of imatinib. Before discontinuation, the median duration of imatinib was 73.2 months (range, 32-109) and the median duration of MR4 was 46.2 months (range, 23.9-98.6). Seven patients experienced loss of major molecular response (MMR) 4.1 months (range, 1.9-6.4) after stopping and so restarted imatinib. The median molecular follow-up after discontinuation was 51 months (range, 6-100) for the nine patients without molecular relapse. The molecular free remission rate was 61% (95% CI, 38-83%), 56% (95% CI, 33-79%) and 56% (95% CI, 33-79%) at 6, 12 and 36 months, respectively. Six of the seven children who experienced molecular relapse after discontinuation regained DMR (median, 4.7 months; range, 2.5-18) after restarting imatinib. No withdrawal syndrome was observed. In univariate analysis, age, sex, Sokal and ELTS scores, imatinib treatment and DMR durations before discontinuation had no influence on treatment free remission. These data suggest that imatinib can be safely discontinued in children with sustained MR4 for at least two years.
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Affiliation(s)
- Frédéric Millot
- Inserm CIC 1402, University Hospital of Poitiers, 86000 Poitiers, France;
| | - Meinolf Suttorp
- Medical Faculty, Pediatric Hemato-Oncology, Technical University Dresden, 01307 Dresden, Germany;
| | - Stéphanie Ragot
- Inserm CIC 1402, University Hospital of Poitiers, 86000 Poitiers, France;
| | - Guy Leverger
- Department of Pediatric Hematology, Trousseau Hospital, 75012 Paris, France;
| | - Jean-Hugues Dalle
- Department of Pediatric Hematology, Robert Debré University Hospital, 75019 Paris, France;
| | - Caroline Thomas
- Department of Pediatric Hematology, University Hospital of Nantes, 44000 Nantes, France;
| | - Nathalie Cheikh
- Department of Pediatric Hematology, University Hospital of Besançon, 25056 Besançon, France;
| | - Brigitte Nelken
- Department of Pediatric Hematology, University Hospital of Lille, 59000 Lille, France;
| | - Marilyne Poirée
- Department of Pediatric Hematology, University Hospital of Nice, 06000 Nice, France;
| | - Geneviève Plat
- Department of Pediatric Hematology, University Hospital of Toulouse, 31000 Toulouse, France;
| | - Birgitta Versluys
- Department of Hematology, University Medical Center Utrecht, 3584 Utrecht, The Netherlands;
| | - Birgitte Lausen
- Department of Pediatrics, Rigshospitalet, 2100 Copenhagen, Denmark;
| | - Marina Borisevich
- Belarusian Research Centre for Pediatric Oncology, Hematology and Immunology, 223053 Minsk, Belarus;
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18
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Rotulo GA, Plat G, Beaupain B, Blanche S, Moushous D, Sicre de Fontbrune F, Leblanc T, Renard C, Barlogis V, Vigue MG, Freycon C, Piguet C, Pasquet M, Fieschi C, Abou-Chahla W, Gandemer V, Rialland F, Millot F, Marie-Cardine A, Paillard C, Levy P, Aladjidi N, Biosse-Duplan M, Bellanné-Chantelot C, Donadieu J. Recurrent bacterial infections, but not fungal infections, characterise patients with ELANE-related neutropenia: a French Severe Chronic Neutropenia Registry study. Br J Haematol 2021; 194:908-920. [PMID: 34340247 DOI: 10.1111/bjh.17695] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/21/2021] [Indexed: 11/29/2022]
Abstract
Among 143 patients with elastase, neutrophil-expressed (ELANE)-related neutropenia enrolled in the French Severe Chronic Neutropenia Registry, 94 were classified as having severe chronic neutropenia (SCN) and 49 with cyclic neutropenia (CyN). Their infectious episodes were classified as severe, mild or oral, and analysed according to their natural occurrence without granulocyte-colony stimulating factor (G-CSF), on G-CSF, after myelodysplasia/acute leukaemia or after haematopoietic stem-cell transplantation. During the disease's natural history period (without G-CSF; 1913 person-years), 302, 957 and 754 severe, mild and oral infectious events, respectively, occurred. Among severe infections, cellulitis (48%) and pneumonia (38%) were the most common. Only 38% of episodes were microbiologically documented. The most frequent pathogens were Staphylococcus aureus (37·4%), Escherichia coli (20%) and Pseudomonas aeruginosa (16%), while fungal infections accounted for 1%. Profound neutropenia (<200/mm3 ), high lymphocyte count (>3000/mm3 ) and neutropenia subtype were associated with high risk of infection. Only the p.Gly214Arg variant (5% of the patients) was associated with infections but not the overall genotype. The first year of life was associated with the highest infection risk throughout life. G-CSF therapy achieved lower ratios of serious or oral infectious event numbers per period but was less protective for patients requiring >10 µg/kg/day. Infections had permanent consequences in 33% of patients, most frequently edentulism.
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Affiliation(s)
- Gioacchino A Rotulo
- Registre des Neutropénies Chroniques, Centre de Référence des Neutropénies Chroniques, Hôpital Trousseau, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Geneviève Plat
- Hématologie Oncologie et Immunologie Pédiatrique, Hôpital des Enfants, Toulouse, France
| | - Blandine Beaupain
- Registre des Neutropénies Chroniques, Centre de Référence des Neutropénies Chroniques, Hôpital Trousseau, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Stéphane Blanche
- APHP, UIHR CEREDIH, Hôpital Necker-Enfants Malade, Paris, France
| | - Despina Moushous
- APHP, UIHR CEREDIH, Hôpital Necker-Enfants Malade, Paris, France
| | | | - Thierry Leblanc
- Department of Pediatric Hematology and Immunology, Hôpital Robert-Debré, APHP, Paris, France
| | - Cécile Renard
- Service de Pédiatrie, Institut d'Hématologie et Oncologie Pédiatrique, Centre Hospitalier Universitaire (CHU) de Lyon, Lyon, France
| | - Vincent Barlogis
- Department of Pediatric Hematology, Timone Hospital, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Marie-Gabrielle Vigue
- Pediatrics, Infectiology, Rhumatology, Hôpital Arnaud-de-Villeneuve, CHRU de Montpellier, Montpellier, France
| | - Claire Freycon
- Service d'Onco-Hématologie Pédiatrique, CHU de Grenoble, Grenoble, France
| | - Christophe Piguet
- Service d'Hémato-Oncologie Pédiatrie, CHU de Limoges, Limoges, France
| | - Marlène Pasquet
- Hématologie Oncologie et Immunologie Pédiatrique, Hôpital des Enfants, Toulouse, France
| | - Claire Fieschi
- Department of Clinical Immunology, Saint-Louis Hospital, APHP, Paris, France
| | - Wadih Abou-Chahla
- Department of Pediatric Hematology, Jeanne-de-Flandre Hospital, CHU de Lille, Lille, France
| | - Virginie Gandemer
- Service d'Hémato-Oncologie Pédiatrique, CHU de Rennes, Rennes, France
| | - Fanny Rialland
- Service d'Oncologie Pédiatrique, CHU de Nantes, Nantes, France
| | - Frédéric Millot
- Service d'Hémato-Oncologie Pédiatrique, CHU de Poitiers, Poitiers, France
| | | | - Catherine Paillard
- Service d'Hématologie Oncologie Pédiatrique, CHU de Strasbourg, Strasbourg, France
| | - Pacifique Levy
- Département de Génétique, DMU BioGeM, CHU Pitié-Salpêtrière, APHP, Sorbonne Université, Paris, France
| | - Nathalie Aladjidi
- Service d'Hémato-Oncologie Pédiatrique, CHU de Bordeaux, Bordeaux, France
| | | | | | - Jean Donadieu
- Registre des Neutropénies Chroniques, Centre de Référence des Neutropénies Chroniques, Hôpital Trousseau, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
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Poch R, Le Louet S, Hélias-Rodzewicz Z, Hachem N, Plat G, Barkaoui MA, Lapillonne H, Delhommeau F, Emile JF, Donadieu J, Héritier S. A circulating subset of BRAF V600E -positive cells in infants with high-risk Langerhans cell histiocytosis treated with BRAF inhibitors. Br J Haematol 2021; 194:745-749. [PMID: 34312844 DOI: 10.1111/bjh.17721] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/02/2021] [Accepted: 07/08/2021] [Indexed: 12/20/2022]
Abstract
BRAF inhibitors are an effective treatment for BRAFV600E -mutated, risk-organ-positive Langerhans cell histiocytosis (RO+ LCH). However, cell-free BRAFV600E DNA often persists during therapy and recurrence frequently occurs after therapy discontinuation. To identify a pathological reservoir of BRAFV600E -mutated cells, we studied peripheral blood cells obtained from six infants with RO+ multisystem (MS) LCH that received targeted therapy. After cell sorting, the BRAFV600E mutation was detected in monocytes (n = 5), B lymphocytes (n = 3), T lymphocytes (n = 2), and myeloid and plasmacytoid dendritic cells (n = 2 each). This biomarker may offer an interesting tool for monitoring the effectiveness of new therapeutic approaches for weaning children with RO+ LCH from targeted therapy.
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Affiliation(s)
- Rita Poch
- INSERM, Centre de Recherche Saint-Antoine, CRSA, Sorbonne Université, Paris, France
| | - Solenne Le Louet
- INSERM, Centre de Recherche Saint-Antoine, CRSA, Sorbonne Université, Paris, France
| | - Zofia Hélias-Rodzewicz
- EA4340-BECCOH, Versailles SQY University, Boulogne, France.,Pathology Department, Ambroise Paré Hospital, AP-AP, Boulogne, France
| | - Nawa Hachem
- INSERM, Centre de Recherche Saint-Antoine, CRSA, Sorbonne Université, Paris, France
| | - Geneviève Plat
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France
| | - Mohamed-Aziz Barkaoui
- Department of Pediatric Hematology and Oncology Trousseau Hospital, French Reference Center for Langerhans Cell Histiocytosis, AP-AP, Paris, France
| | - Hélène Lapillonne
- INSERM, Centre de Recherche Saint-Antoine, CRSA, Sorbonne Université, Paris, France
| | - François Delhommeau
- INSERM, Centre de Recherche Saint-Antoine, CRSA, Sorbonne Université, Paris, France
| | - Jean-François Emile
- EA4340-BECCOH, Versailles SQY University, Boulogne, France.,Pathology Department, Ambroise Paré Hospital, AP-AP, Boulogne, France
| | - Jean Donadieu
- INSERM, Centre de Recherche Saint-Antoine, CRSA, Sorbonne Université, Paris, France.,EA4340-BECCOH, Versailles SQY University, Boulogne, France.,Department of Pediatric Hematology and Oncology Trousseau Hospital, French Reference Center for Langerhans Cell Histiocytosis, AP-AP, Paris, France
| | - Sébastien Héritier
- INSERM, Centre de Recherche Saint-Antoine, CRSA, Sorbonne Université, Paris, France.,Department of Pediatric Hematology and Oncology Trousseau Hospital, French Reference Center for Langerhans Cell Histiocytosis, AP-AP, Paris, France
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20
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Viatgé T, Noel-Savina E, Prévot G, Faviez G, Plat G, De Boissezon X, Cintas P, Didier A. [Parsonage-Turner syndrome following severe SARS-CoV-2 infection]. Rev Mal Respir 2021; 38:853-858. [PMID: 34325956 PMCID: PMC8233958 DOI: 10.1016/j.rmr.2021.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 06/01/2021] [Indexed: 01/08/2023]
Abstract
Introduction Les complications de l’infection par le SARS-CoV-2 peuvent affecter la sphère neurologique ; il s’agit habituellement de cas de polyradiculonévrite aiguë inflammatoire ou de plexite. Observation Le cas clinique rapporté concerne un patient de 20 ans sans comorbidités, atteint d’une infection sévère à la COVID-19 compliquée d’un syndrome de détresse respiratoire aiguë, avec manifestations thromboemboliques et surinfection bactérienne. Ce patient souffrait également d’un trouble neurologique non spécifique lié au SARS-Cov-2 avec une paralysie pseudobulbaire (IRM, EMG et ponction lombaire étaient normaux), associé à des troubles neurologiques persistants 4 mois plus tard, caractérisés par un déficit à prédominance motrice de l’épaule gauche et une insuffisance respiratoire. Le bilan respiratoire et neurologique conclut à un syndrome de Parsonage-Turner, ou amyotrophie névralgique, affectant les racines nerveuses en C5-C6, le nerf pectoral latéral et le nerf phrénique à l’origine de l’amyotrophie de la ceinture scapulaire et de la paralysie du diaphragme gauche. Conclusion Ce cas montre que la dyspnée persistante après une infection à la COVID-19 doit faire rechercher une cause diaphragmatique et que celle-ci n’est pas toujours secondaire à la neuropathie de réanimation, mais peut aussi être le témoin d’une amyotrophie névralgique.
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Affiliation(s)
- T Viatgé
- Service de pneumologie, hôpital Larrey, CHU de Toulouse, 31059 Toulouse cedex 9, France.
| | - E Noel-Savina
- Service de pneumologie, hôpital Larrey, CHU de Toulouse, 31059 Toulouse cedex 9, France
| | - G Prévot
- Service de pneumologie, hôpital Larrey, CHU de Toulouse, 31059 Toulouse cedex 9, France
| | - G Faviez
- Service de pneumologie, hôpital Larrey, CHU de Toulouse, 31059 Toulouse cedex 9, France
| | - G Plat
- Service de pneumologie, hôpital Larrey, CHU de Toulouse, 31059 Toulouse cedex 9, France
| | - X De Boissezon
- Service de médecine physique et de réadaptation, hôpital Rangueil, CHU de Toulouse, 31059 Toulouse cedex 9, France
| | - P Cintas
- Service de neurologie, hôpital Purpan, CHU de Toulouse, 31059 Toulouse cedex 9, France
| | - A Didier
- Service de pneumologie, hôpital Larrey, CHU de Toulouse, 31059 Toulouse cedex 9, France
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21
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Rigaud C, Abbas R, Grand D, Minard-Colin V, Aladjidi N, Buchbinder N, Garnier N, Plat G, Couec ML, Duplan M, Lambilliotte A, Schmitt C, Leblanc T, Lamant L, Brugières L. Should treatment of ALK-positive anaplastic large cell lymphoma be stratified according to minimal residual disease? Pediatr Blood Cancer 2021; 68:e28982. [PMID: 33687135 DOI: 10.1002/pbc.28982] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 07/22/2020] [Revised: 01/30/2021] [Accepted: 02/12/2021] [Indexed: 11/09/2022]
Abstract
In anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALK+ ALCL), positive minimal residual disease (MRD+) after the first chemotherapy course was proven of strong prognostic significance. We aimed to validate these results in 138 French patients. Eighty-seven patients had a detectable minimal disseminated disease at diagnosis (MDD+). Early MRD assessment was performed in 33 of 87 patients and was positive in 18 and negative in 15 (MRD-). Three-year progression-free survival was significantly correlated with the MDD/MRD status: 81.1% in MDD-, 69.6% in MDD+/MRD-, and 15.2% in MDD+/MRD+ patients. In conclusion, we confirmed on an independent cohort that the MDD/MRD status has strong prognosis significance in ALK+ ALCL.
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Affiliation(s)
- Charlotte Rigaud
- Children and Adolescent Oncology Department, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
| | - Rachid Abbas
- Department of Biostatistics and Epidemiology, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
| | - David Grand
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Véronique Minard-Colin
- Children and Adolescent Oncology Department, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
| | | | | | | | - Geneviève Plat
- Pediatric Oncology, Toulouse University Hospital, Toulouse, France
| | | | - Mylène Duplan
- Pediatric Oncology, Angers University Hospital, Angers, France
| | | | | | - Thierry Leblanc
- Pediatric Hematology, Robert Debré Hospital-APHP, Paris, France
| | - Laurence Lamant
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Laurence Brugières
- Children and Adolescent Oncology Department, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
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22
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Sirvent N, Suciu S, De Moerloose B, Ferster A, Mazingue F, Plat G, Yakouben K, Uyttebroeck A, Paillard C, Costa V, Simon P, Pluchart C, Poirée M, Minckes O, Millot F, Freycon C, Maes P, Hoyoux C, Cavé H, Rohrlich P, Bertrand Y, Benoit Y. CNS-3 status remains an independent adverse prognosis factor in children with acute lymphoblastic leukemia (ALL) treated without cranial irradiation: Results of EORTC Children Leukemia Group study 58951. Arch Pediatr 2021; 28:411-416. [PMID: 34034929 DOI: 10.1016/j.arcped.2021.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 02/25/2021] [Accepted: 04/16/2021] [Indexed: 11/25/2022]
Abstract
AIM To evaluate the prognostic significance of initial central nervous system (CNS) involvement of children with acute lymphoblastic leukemia (ALL) enrolled in the EORTC 58951 trial. PATIENTS AND METHODS From 1998 to 2008, 1930 ALL patients were included in the randomized EORTC 58951 trial. Overall treatment intensity was adjusted according to known prognostic factors including the level of minimal residual disease after induction treatment. CNS-directed therapy comprised four to 11 courses of i.v. methotrexate (5g/m2), and 10 to 19 intrathecal chemotherapy injections, depending on risk group and CNS status. Cranial irradiation was omitted for all patients. RESULTS The overall 8-year event-free survival (EFS) and overall survival (OS) rates were 81.3% and 88.1%, respectively. In the CNS-1, TPL+, CNS-2, and CNS-3 groups, the 8-year EFS rates were 82.1%, 77.1%, 78.3%, and 57.4%, respectively. Multivariable analysis indicated that initial CNS-3 status, but not CNS-2 or TLP+, was an independent adverse predictor of outcome. The 8-year incidence of isolated CNS relapse was 1.7% and of isolated or combined CNS relapse it was 3.7%. NCI high-risk group, male sex, CNS-2 and CNS-3 status were independent predictors for a higher incidence of any CNS relapse. CONCLUSIONS CNS-3 status remains associated with poor prognosis and requires intensification of both systemic and CNS-directed therapy. This trial was registered at https://clinicaltrials.gov/under/NCT00003728.
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Affiliation(s)
- N Sirvent
- Department of Pediatric Hematology-Oncology, CHU, Montpellier, France; University Montpellier, Montpellier, France.
| | - S Suciu
- EORTC Headquarters, Brussels, Belgium
| | - B De Moerloose
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - A Ferster
- Department of Pediatric Hematology-Oncology, Children's University Hospital Queen Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - F Mazingue
- Department of Pediatric Hematology-Oncology, CHRU, Lille, France
| | - G Plat
- Department of Pediatric Hematology-Oncology, CHU-Hôpital Purpan, Toulouse, France
| | - K Yakouben
- Department of Pediatric Hematology, Robert-Debré Hospital, AP-HP, Paris, France
| | - A Uyttebroeck
- Department of Pediatric Hematology-Oncology, University Hospital Gasthuisberg, Leuven, Belgium
| | - C Paillard
- Department of Pediatric Hematology-Oncology, University Hospital Hautepierre, Strasbourg, France
| | - V Costa
- Department of Pediatrics, Portuguese Oncology Institute, Porto, Portugal
| | - P Simon
- Pediatric Hematology Unit, CHU Jean-Minjoz Hospital, Besançon, France
| | - C Pluchart
- Department of Pediatric Hematology-Oncology, American Memorial Hospital, Reims, France
| | - M Poirée
- Department of Pediatric Hematology-Oncology, CHU Nice, Nice, France
| | - O Minckes
- Department of Pediatric Hematology-Oncology, CHU, Caen, France
| | - F Millot
- Pediatric Oncology Unit, University Hospital, Poitiers, France
| | - C Freycon
- Department of Pediatric Oncology, University Hospital, Grenoble, France
| | - P Maes
- Department of Pediatrics, University Hospital Antwerp, Antwerp, Belgium
| | - C Hoyoux
- Department of Pediatrics, CHR de la Citadelle, Liège, Belgium
| | - H Cavé
- Department of Genetics, Assistance publique-Hôpitaux de Paris (AP-HP), Robert-Debré Hospital, Paris, France; INSERM UMR 1131, University Institute of Hematology, University Paris-Diderot, Paris Sorbonne Cité, Paris, France
| | - P Rohrlich
- Department of Pediatric Hematology-Oncology, CHU Nice, Nice, France
| | - Y Bertrand
- Institute of Pediatric Hematology and Oncology (IHOP), Hospices Civils de Lyon, University Lyon 1, Lyon, France
| | - Y Benoit
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent University, Ghent, Belgium
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23
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Héluain V, Guilleminault L, Hermant C, Plat G, Didier A, Guibert N. [Bronchial thermoplasty for severe asthma]. Rev Mal Respir 2021; 38:289-296. [PMID: 33531186 DOI: 10.1016/j.rmr.2021.01.002] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/13/2020] [Indexed: 11/29/2022]
Abstract
Bronchial thermoplasty has been developed over the past fifteen years and is the first endoscopic technique approved in the management of severe asthma. This procedure uses radiofrequency applied to the airway wall to target bronchial smooth muscle. Patients treated in randomized controlled trials have experienced significant decreases in the use of rescue medications, urgent care visits, and exacerbations rate. The lack of reliable predictive markers of response to this expensive, minimally-invasive technique currently makes it a last-line treatment option. We review the principles and supposed mechanisms of action of this treatment, the results from the main trials and clinical registry data and discuss the place of bronchial thermoplasty in the current management of severe asthma. We also discuss perspectives to better characterize the mechanisms of action and identify the responder phenotype, the main challenge of current studies.
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Affiliation(s)
- V Héluain
- Service de pneumologie, hôpital Larrey, université Paul-Sabatier, CHU Toulouse, Toulouse, France
| | - L Guilleminault
- Service de pneumologie, hôpital Larrey, université Paul-Sabatier, CHU Toulouse, Toulouse, France; Centre de physiopathologie Toulouse Purpan, INSERM U1043, CNRS UMR 5282, université Toulouse III, Toulouse, France; INSERM, F-CRIN, Clinical Research Initiative In Severe Asthma: a Lever for Innovation & Science (CRISALIS), Toulouse, France
| | - C Hermant
- Service de pneumologie, hôpital Larrey, université Paul-Sabatier, CHU Toulouse, Toulouse, France
| | - G Plat
- Service de pneumologie, hôpital Larrey, université Paul-Sabatier, CHU Toulouse, Toulouse, France
| | - A Didier
- Service de pneumologie, hôpital Larrey, université Paul-Sabatier, CHU Toulouse, Toulouse, France; Centre de physiopathologie Toulouse Purpan, INSERM U1043, CNRS UMR 5282, université Toulouse III, Toulouse, France; INSERM, F-CRIN, Clinical Research Initiative In Severe Asthma: a Lever for Innovation & Science (CRISALIS), Toulouse, France
| | - N Guibert
- Service de pneumologie, hôpital Larrey, université Paul-Sabatier, CHU Toulouse, Toulouse, France.
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24
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Lopez R, Plat G, Bertrand Y, Ducassou S, Saultier P, Berbis J, Pochon C, Hamidou Z, Poiree M, Tabone MD, Kanold J, Dalle JH, Gandemer V, Paillard C, Sirvent N, Plantaz D, Thouvenin S, Pellier I, Ansoborlo S, Leverger G, Baruchel A, Auquier P, Michel G. Testosterone deficiency in men surviving childhood acute leukemia after treatment with hematopoietic stem cell transplantation or testicular radiation: an L.E.A. study. Bone Marrow Transplant 2021; 56:1422-1425. [PMID: 33454725 DOI: 10.1038/s41409-020-01180-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 10/21/2020] [Accepted: 11/27/2020] [Indexed: 11/09/2022]
Abstract
We included 255 patients from the L.E.A. French long-term follow-up cohort. All had received hematopoietic stem cell transplantation (HSCT) and/or testicular radiation for childhood acute leukemia and were older than 18 years at last L.E.A. evaluation. Total testosterone deficiency was defined as a <12 nmol/l level or by substitutive therapy, partial deficiency as normal testosterone with elevated luteinizing hormone (>10 UI/l). After myeloablative total body irradiation (n = 178), 55.6% had total deficiency, 15.7% partial deficiency, and 28.7% were normal. A 4-6 Gy testicular boost and a younger age at HSCT increased significantly the risk. After a Busulfan-containing myeloablative conditioning regimen (n = 53), 28.3% had total deficiency, 15.1% partial deficiency, 56.6% were normal (62.5% vs. 0% in patients without or with additional testicular radiation). A 24-Gy testicular radiation without HSCT induced total or partial deficiency in 71.4% and 28.6%, respectively (n = 21). Total testosterone deficiency increased the risk of metabolic syndrome: 25% vs. 12.1% in men with partial testosterone deficiency and 8.8% when Leydig cell function was normal (p = 0.031).
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Affiliation(s)
- Romain Lopez
- Department of Pediatric Hematology and Oncology, University Hospital of Toulouse, Toulouse, France
| | - Geneviève Plat
- Department of Pediatric Hematology and Oncology, University Hospital of Toulouse, Toulouse, France
| | - Yves Bertrand
- Department of Pediatric Hematology and Oncology, University Hospital of Lyon, Lyon, France
| | - Stéphane Ducassou
- Department of Pediatric Hematology and Oncology, University Hospital of Bordeaux, Bordeaux, France
| | - Paul Saultier
- Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France
| | - Julie Berbis
- Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France
| | - Cécile Pochon
- Department of Pediatric Hematology and Oncology, Children's Hospital of Brabois, Vandoeuvre Les Nancy, France
| | - Zeinab Hamidou
- Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France
| | - Marilyne Poiree
- Department of Pediatric Hematology and Oncology, University Hospital L'Archet, Nice, France
| | - Marie-Dominique Tabone
- Department of Pediatric Hematology and Oncology, Trousseau University Hospital, APHP, Paris, France
| | - Justyna Kanold
- Department of Pediatric Hematology and Oncology, CIC Inserm 501, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Jean-Hugues Dalle
- Pediatric Hematology Department, Robert Debré Hospital, Paris, France
| | - Virginie Gandemer
- Department of Pediatric Hematology and Oncology, University Hospital of Rennes, Rennes, France
| | - Catherine Paillard
- Department of Pediatric Hematology-Oncology, University Hospital, Strasbourg, France
| | - Nicolas Sirvent
- Department of Pediatric Hematology and Oncology, University Hospital, Montpellier, France
| | - Dominique Plantaz
- Department of Pediatric Hematology-Oncology, University Hospital of Grenoble, Grenoble, France
| | - Sandrine Thouvenin
- Department of Pediatric Hematology-Oncology, University Hospital St Etienne, St Etienne, France
| | - Isabelle Pellier
- Department of Pediatric Hematology-Oncology, University Hospital of Angers, Angers, France
| | - Sophie Ansoborlo
- Department of Pediatric Hematology and Oncology, University Hospital of Bordeaux, Bordeaux, France
| | - Guy Leverger
- Department of Pediatric Hematology and Oncology, Trousseau University Hospital, APHP, Paris, France
| | - André Baruchel
- Pediatric Hematology Department, Robert Debré Hospital, Paris, France
| | - Pascal Auquier
- Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France
| | - Gérard Michel
- Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France. .,Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France.
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25
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Olivier-Gougenheim L, Arfeuille C, Suciu S, Sirvent N, Plat G, Ferster A, de Moerloose B, Domenech C, Uyttebroeck A, Rohrlich PS, Cavé H, Bertrand Y. Pediatric randomized trial EORTC CLG 58951: Outcome for adolescent population with acute lymphoblastic leukemia. Hematol Oncol 2020; 38:763-772. [PMID: 32809224 DOI: 10.1002/hon.2791] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 07/01/2020] [Revised: 08/08/2020] [Accepted: 08/11/2020] [Indexed: 11/08/2022]
Abstract
Over the years, the prognosis of adolescents treated for acute lymphoblastic leukemia (ALL) has improved. However, this age group still represents a challenge with an overall survival (OS) of 60% compared to 85% in younger children. Herein, we report the outcome of adolescents treated in the European Organisation for Research and Treatment of Cancer (EORTC) 58951 clinical trial. EORTC 58951 clinical trial included patients with de novo ALL between 1998 and 2008. For this study, we analyzed data of all adolescents between 15 and under 18. Data from 97 adolescents were analyzed, 70 had B-lineage and 27 had T-lineage ALL. The 8-year event-free survival (EFS) and OS for the B-cell precursor ALL cases were 72.3% (59.4%-81.7%) and 80.8% (67.4%-89.1%), respectively. For the T-lineage, the 8-year EFS and OS were 57.4% (36.1%-74.0%) and 59.0% (36.1%-76.2%), respectively. "B-other" ALL, defined as BCP-ALL lacking any known recurrent genetic abnormalities were more frequent in our adolescent population (52.8%) than in younger children (27.1%). Outcome of adolescents in the EORTC 58951 study is supporting the findings that adolescents have better outcome in pediatric compared to adults' trials. Nevertheless, in pediatric studies, adolescents still have a worse prognosis than younger children. Despite the fact that specific unfavorable characteristics may be linked to the adolescent population, a careful study and characterization of adolescents "B-other" genetic abnormalities in ALL is critical to improve the outcome of this population.
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Affiliation(s)
- Laura Olivier-Gougenheim
- Institute of Pediatric Hematology and Oncology, Hospices Civils de Lyon, Claude Bernard Lyon I University, Lyon, France
| | - Chloe Arfeuille
- Department of Genetic Biochemistry, Robert-Debré Hospital, AP-HP and University of Paris-Diderot, Paris, France
| | - Stefan Suciu
- European Organization for Research and Treatment of Cancer (EORTC), EORTC Headquarters, Brussels, Belgium
| | - Nicolas Sirvent
- Department of Pediatric and Adolescent Hematology-Oncology, Arnaud de Villeneuve Children's Hospital, Montpellier, France
| | - Geneviève Plat
- Department of Pediatric Hematology and Oncology, Toulouse University Hospital, Toulouse, France
| | - Alina Ferster
- Department of Hematology-Oncology, Reine Fabiola Children Hospital, Brussels, Belgium
| | | | - Carine Domenech
- Institute of Pediatric Hematology and Oncology, Hospices Civils de Lyon, Claude Bernard Lyon I University, Lyon, France
| | - Anne Uyttebroeck
- Department of Pediatric Hematology-Oncology, University Hospitals Leuven, Leuven, Belgium
| | | | - Helene Cavé
- Department of Genetic Biochemistry, Robert-Debré Hospital, AP-HP and University of Paris-Diderot, Paris, France
| | - Yves Bertrand
- Institute of Pediatric Hematology and Oncology, Hospices Civils de Lyon, Claude Bernard Lyon I University, Lyon, France
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Barkaoui M, Queheille E, Aladjidi N, Plat G, Jeziorski E, Moshous D, Lambilliotte A, Kebaili K, Pacquement H, Leverger G, Mansuy L, Entz‐Werlé N, Bodet D, Schneider P, Pagnier A, Lutun A, Gillibert‐Yvert M, Millot F, Toutain F, Reguerre Y, Thomas C, Tazi A, Emile J, Donadieu J, Héritier S. Long‐term follow‐up of children with risk organ‐negative Langerhans cell histiocytosis after 2‐chlorodeoxyadenosine treatment. Br J Haematol 2020; 191:825-834. [DOI: 10.1111/bjh.16944] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/13/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Mohamed‐Aziz Barkaoui
- French Reference Center for Langerhans Cell HistiocytosisTrousseau Hospital Paris France
| | - Emma Queheille
- French Reference Center for Langerhans Cell HistiocytosisTrousseau Hospital Paris France
| | - Nathalie Aladjidi
- Department of Pediatric Hematology and Oncology Centre Hospitalo‐Universitaire de Bordeaux Bordeaux France
| | - Geneviève Plat
- Department of Pediatric Hematology and Oncology Centre Hospitalo‐Universitaire de Toulouse Toulouse France
| | - Eric Jeziorski
- Department of Paediatric Hôpital Arnaud de VilleneuveCentre Hospitalo‐Universitaire de Montpellier Montpellier France
| | - Despina Moshous
- Department of Pediatric Immunology, Hematology and Rheumatology Necker HospitalAssistance Publique–Hôpitaux de Paris Paris France
- Institut Imagine Paris UniversitySorbonne‐Paris‐Cité Paris France
| | - Anne Lambilliotte
- Department of Pediatric Hematology and Oncology Centre Hospitalo‐Universitaire de Lille Lille France
| | - Kamila Kebaili
- Department of Paediatric Oncology Institut d'Hémato‐Oncologie Pediatrique Lyon France
| | - Hélène Pacquement
- Pediatric, Adolescent and Young Adult Oncology Department Institut Curie Medical Center Paris France
| | - Guy Leverger
- Department of Pediatric Hematology and Oncology Faculté de médecine, Trousseau Hospital Sorbonne UniversitéAssistance Publique–Hôpitaux de Paris Paris France
| | - Ludovic Mansuy
- Department of Pediatric Hematology and Oncology Centre Hospitalo‐Universitaire de Nancy Vandœuvre‐lès‐Nancy France
| | - Natacha Entz‐Werlé
- Department of Pediatric Hematology and Oncology Centre Hospitalo‐Universitaire de Strasbourg Strasbourg France
| | - Damien Bodet
- Department of Pediatric Hematology and Oncology Centre Hospitalo‐Universitaire de Cean Cean France
| | - Pascale Schneider
- Department of Pediatric Hematology and Oncology Centre Hospitalo‐Universitaire de Rouen Rouen France
| | - Anne Pagnier
- Department of Pediatric Hematology and Oncology Centre Hospitalo‐Universitaire de Grenoble Grenoble France
| | - Anne Lutun
- Department of Pediatric Hematology and Oncology Centre Hospitalo‐Universitaire d'Amiens Amiens France
| | - Marion Gillibert‐Yvert
- Department of Pediatric Hematology and Oncology Centre Hospitalo‐Universitaire de Tours Tours France
| | - Fréderic Millot
- Department of Pediatric Hematology and Oncology Centre Hospitalo‐Universitaire de Poitiers Poitiers France
| | - Fabienne Toutain
- Department of Pediatric Hematology and Oncology Centre Hospitalo‐Universitaire de Rennes Rennes France
| | - Yves Reguerre
- Department of Pediatric Hematology and Oncology Centre Hospitalo‐Universitaire Saint Denis de la Réunion St Denis France
| | - Caroline Thomas
- Department of Pediatric Hematology and Oncology Centre Hospitalo‐Universitaire de Nantes Nantes France
| | - Abdelatif Tazi
- Pneumology Department Saint‐Louis HospitalAssistance Publique–Hôpitaux de Paris Paris France
- Université de ParisINSERM U976 Paris France
| | | | - Jean Donadieu
- French Reference Center for Langerhans Cell HistiocytosisTrousseau Hospital Paris France
- Department of Pediatric Hematology and Oncology Faculté de médecine, Trousseau Hospital Sorbonne UniversitéAssistance Publique–Hôpitaux de Paris Paris France
| | - Sébastien Héritier
- French Reference Center for Langerhans Cell HistiocytosisTrousseau Hospital Paris France
- Department of Pediatric Hematology and Oncology Faculté de médecine, Trousseau Hospital Sorbonne UniversitéAssistance Publique–Hôpitaux de Paris Paris France
- EA4340UVSQUniversité Paris‐Saclay Boulogne‐Billancourt France
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Piette C, Suciu S, Bertrand Y, Uyttebroeck A, Vandecruys E, Plat G, Paillard C, Pluchart C, Sirvent N, Maurus R, Poirée M, Simon P, Ferster A, Hoyoux C, Mazingue F, Paulus R, Freycon C, Thomas C, Philippet P, Gilotay C, van der Werff Ten Bosch J, Rohrlich PS, Benoit Y. Long-term outcome evaluation of medium/high risk acute lymphoblastic leukaemia children treated with or without cranial radiotherapy in the EORTC 58832 randomized study. Br J Haematol 2019; 189:351-362. [PMID: 31837008 DOI: 10.1111/bjh.16337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/23/2019] [Indexed: 01/25/2023]
Abstract
We investigated the long-term outcome, the incidence of second neoplasms (SN) and the rate of late adverse effects (LAE) in children with central nervous system (CNS) negative medium/high-risk de novo acute lymphoblastic leukaemia (ALL), in first complete remission (CR1) at end of late intensification, randomized to receive no cranial radiotherapy (No CRT, n = 92) versus CRT (standard arm, n = 84) in the non-inferiority EORTC 58832 study (1983-1989). Median follow-up was 20 years (range 4-32 years). The 25-year disease-free survival rate (±SE) was 67·4 ± 4·9% without CRT and 70·2 ± 5·0% with CRT. The 25-year incidence of isolated (6·5 ± 2·6% vs. 4·8 ± 2·3%) and any CNS relapse {8·7 ± 2·9% vs. 11·9 ± 3·5%; hazard ratio (HR) 0·71 [95% confidence interval (CI) 0·28-1·79]; test of non-inferiority: P = 0·01} was not increased without CRT. The 25-year SN incidence in CR1 was 7·9 ± 4·6% vs. 11·0 ± 4·2%. The 25-year event-free and overall survival rates were quite similar in both arms [59·5 ± 6·3% vs. 60·5 ± 5·9%, HR 0·94 (95% CI 0·57-1·52), and 78·1 ± 4·3% vs. 78·5 ± 4·5%, HR 1·00 (95% CI 0·53-1·88)]. Omission of CRT was associated with dramatic decrease in CNS and endocrine LAE rates. In conclusion, our data suggest that, with proper systemic and intrathecal CNS prophylaxis, CRT could totally be omitted in CR1 without jeopardizing survival, while decreasing LAE in childhood ALL.
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Affiliation(s)
- Caroline Piette
- Division of Haematology-Oncology, Department of Paediatrics, University Hospital Liège and University of Liège, Liège, Belgium
| | | | - Yves Bertrand
- Department of Paediatric Onco-Haematology, Lyon University Hospital, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Anne Uyttebroeck
- Department of Paediatric Haematology-Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Els Vandecruys
- Department of Paediatric Haematology-Oncology, Ghent University Hospital, Ghent, Belgium
| | - Geneviève Plat
- Department of Paediatric Onco-Haematology, Purpan University Hospital, Toulouse, France
| | - Catherine Paillard
- Department of Haematology, Hautepierre University Hospital, Strasbourg, France
| | - Claire Pluchart
- Department of Paediatric Onco-Haematology, Reims University Hospital, Reims, France
| | - Nicolas Sirvent
- Department of Paediatric Onco-Haematology, Montpellier University Hospital, Montpellier, France
| | - Renée Maurus
- Department of Paediatric Onco-Haematology, Saint-Pierre Hospital, Brussel, Belgium
| | - Maryline Poirée
- Department of Paediatric Onco-Haematology, Nice University Hospital, Nice, France
| | - Pauline Simon
- Department of Paediatric Onco-Haematology, Besançon University Hospital, Besançon, France
| | - Alina Ferster
- Department of Paediatric Onco-Haematology, Hôpital Universitaire des Enfants Reine Fabiola (ULB), Brussels, Belgium
| | - Claire Hoyoux
- Division of Haematology-Oncology, Department of Paediatrics, University Hospital Liège and University of Liège, Liège, Belgium
| | - Françoise Mazingue
- Department of Paediatric Haematology-Oncology, Lille University Hospital, Lille, France
| | | | - Claire Freycon
- Department of Paediatric Onco-Haematology, Grenoble University Hospital, La Tronche, France
| | - Caroline Thomas
- Department of Paediatric Onco-Haematology, Nantes University Hospital, Nantes, France
| | | | | | | | - Pierre S Rohrlich
- Department of Paediatric Onco-Haematology, Nice University Hospital, Nice, France
| | - Yves Benoit
- Department of Paediatric Haematology-Oncology, Ghent University Hospital, Ghent, Belgium
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Donadieu J, Larabi IA, Tardieu M, Visser J, Hutter C, Sieni E, Kabbara N, Barkaoui M, Miron J, Chalard F, Milne P, Haroche J, Cohen F, Hélias-Rodzewicz Z, Simon N, Jehanne M, Kolenova A, Pagnier A, Aladjidi N, Schneider P, Plat G, Lutun A, Sonntagbauer A, Lehrnbecher T, Ferster A, Efremova V, Ahlmann M, Blanc L, Nicholson J, Lambilliote A, Boudiaf H, Lissat A, Svojgr K, Bernard F, Elitzur S, Golan M, Evseev D, Maschan M, Idbaih A, Slater O, Minkov M, Taly V, Collin M, Alvarez JC, Emile JF, Héritier S. Vemurafenib for Refractory Multisystem Langerhans Cell Histiocytosis in Children: An International Observational Study. J Clin Oncol 2019; 37:2857-2865. [PMID: 31513482 PMCID: PMC6823889 DOI: 10.1200/jco.19.00456] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [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] [Accepted: 07/17/2019] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Off-label use of vemurafenib (VMF) to treat BRAFV600E mutation-positive, refractory, childhood Langerhans cell histiocytosis (LCH) was evaluated. PATIENTS AND METHODS Fifty-four patients from 12 countries took VMF 20 mg/kg/d. They were classified according to risk organ involvement: liver, spleen, and/or blood cytopenia. The main evaluation criteria were adverse events (Common Terminology Criteria for Adverse Events [version 4.3]) and therapeutic responses according to Disease Activity Score. RESULTS LCH extent was distributed as follows: 44 with positive and 10 with negative risk organ involvement. Median age at diagnosis was 0.9 years (range, 0.1 to 6.5 years). Median age at VMF initiation was 1.8 years (range, 0.18 to 14 years), with a median follow-up of 22 months (range, 4.3 to 57 months), whereas median treatment duration was 13.9 months (for 855 patient-months). At 8 weeks, 38 complete responses and 16 partial responses had been achieved, with the median Disease Activity Score decreasing from 7 at diagnosis to 0 (P < .001). Skin rash, the most frequent adverse event, affected 74% of patients. No secondary skin cancer was observed. Therapeutic plasma VMF concentrations (range, 10 to 20 mg/L) seemed to be safe and effective. VMF discontinuation for 30 patients led to 24 LCH reactivations. The blood BRAFV600E allele load, assessed as circulating cell-free DNA, decreased after starting VMF but remained positive (median, 3.6% at diagnosis, and 1.6% during VMF treatment; P < .001) and was associated with a higher risk of reactivation at VMF discontinuation. None of the various empirical therapies (hematopoietic stem-cell transplantation, cladribine and cytarabine, anti-MEK agent, vinblastine, etc) used for maintenance could eradicate the BRAFV600E clone. CONCLUSION VMF seemed safe and effective in children with refractory BRAFV600E-positive LCH. Additional studies are needed to find effective maintenance therapy approaches.
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Affiliation(s)
| | | | | | | | | | - Elena Sieni
- Azienda Ospedaliero-Universitaria A. Meyer, Florence, Italy
| | - Nabil Kabbara
- Centre Hospitalier du Nord, Zgharta, Lebanon
- Rafic Hariri University Hospital, Beirut, Lebanon
| | | | | | | | - Paul Milne
- Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Julien Haroche
- Centre Hospitalier Universitaire Pitié-Salpêtrière, Paris, France
| | - Fleur Cohen
- Centre Hospitalier Universitaire Pitié-Salpêtrière, Paris, France
| | | | | | - Mathilde Jehanne
- Centre Hospitalier Universitaire Félix-Guyon (Saint-Denis), La Réunion, France
| | | | - Anne Pagnier
- Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | | | | | - Geneviève Plat
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Anne Lutun
- Centre Hospitalier Universitaire d’Amiens, Amiens, France
| | | | | | - Alina Ferster
- Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium
| | | | - Martina Ahlmann
- Universitätsklinikum Münster Klinik für Kinder- und Jugendmedizin-Pädiatrische Hämatologie und Onkologie, Münster, Germany
| | - Laurence Blanc
- Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | | | | | | | | | - Karel Svojgr
- University Hospital Motol, Prague, Czech Republic
| | | | - Sarah Elitzur
- Schneider Children’s Medical Center, Petah Tikva, Israel
| | - Michal Golan
- The Edmond and Lily Safra Children’s Hospital, Tel-Hahsomer, Israel
| | - Dmitriy Evseev
- Dmitriy Rogachev National Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Michael Maschan
- Dmitriy Rogachev National Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Ahmed Idbaih
- Centre Hospitalier Universitaire La Pitié-Salpêtrière–Charles Foix, Paris, France
| | - Olga Slater
- Great Ormond Street Hospital, London, United Kingdom
| | | | | | - Matthew Collin
- Newcastle University, Newcastle upon Tyne, United Kingdom
| | | | | | - Sébastien Héritier
- Trousseau Hospital, Paris, France
- Université Paris-Saclay, Boulogne-Billancourt, France
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Dubot P, Sabourdy F, Plat G, Jubert C, Cancès C, Broué P, Touati G, Levade T. First Report of a Patient with MPS Type VII, Due to Novel Mutations in GUSB, Who Underwent Enzyme Replacement and Then Hematopoietic Stem Cell Transplantation. Int J Mol Sci 2019; 20:ijms20215345. [PMID: 31661765 PMCID: PMC6861985 DOI: 10.3390/ijms20215345] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 10/07/2019] [Revised: 10/23/2019] [Accepted: 10/24/2019] [Indexed: 11/25/2022] Open
Abstract
We report the case of a boy who was diagnosed with mucopolysaccharidosis (MPS) VII at two weeks of age. He harbored three missense β-glucuronidase (GUSB) variations in exon 3: two novel, c.422A>C and c.424C>T, inherited from his mother, and the rather common c.526C>T, inherited from his father. Expression of these variations in transfected HEK293T cells demonstrated that the double mutation c.422A>C;424C>T reduces β-glucuronidase enzyme activity. Enzyme replacement therapy (ERT), using UX003 (vestronidase alfa), was started at four months of age, followed by a hematopoietic stem cell allograft transplantation (HSCT) at 13 months of age. ERT was well tolerated and attenuated visceromegaly and skin infiltration. After a severe skin and gut graft-versus-host disease, ERT was stopped six months after HSCT. The last follow-up examination (at the age of four years) revealed a normal psychomotor development, stabilized growth curve, no hepatosplenomegaly, and no other organ involvement. Intriguingly, enzyme activity had normalized in leukocytes but remained low in plasma. This case report illustrates: (i) The need for an early diagnosis of MPS, and (ii) the possible benefit of a very early enzymatic and/or cellular therapy in this rare form of lysosomal storage disease.
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Affiliation(s)
- Patricia Dubot
- Laboratoire de Biochimie Métabolique, Centre de Référence en Maladies Héréditaires du Métabolisme, Institut Fédératif de Biologie, CHU de Toulouse, 31059 Toulouse cedex 9, France.
- INSERM UMR1037, CRCT (Cancer Research Center of Toulouse), Université Paul Sabatier, 31037 Toulouse, France.
| | - Frédérique Sabourdy
- Laboratoire de Biochimie Métabolique, Centre de Référence en Maladies Héréditaires du Métabolisme, Institut Fédératif de Biologie, CHU de Toulouse, 31059 Toulouse cedex 9, France.
- INSERM UMR1037, CRCT (Cancer Research Center of Toulouse), Université Paul Sabatier, 31037 Toulouse, France.
| | - Geneviève Plat
- Service d'Hématologie Pédiatrique, CHU de Toulouse, 31058 Toulouse, France.
| | - Charlotte Jubert
- Service d'Hématologie Pédiatrique, CHU de Bordeaux, 33076 Bordeaux, France.
| | - Claude Cancès
- Hôpital des Enfants, Centre de Référence en Maladies Héréditaires du Métabolisme, CHU de Toulouse, 31059 Toulouse, France.
| | - Pierre Broué
- Hôpital des Enfants, Centre de Référence en Maladies Héréditaires du Métabolisme, CHU de Toulouse, 31059 Toulouse, France.
| | - Guy Touati
- Hôpital des Enfants, Centre de Référence en Maladies Héréditaires du Métabolisme, CHU de Toulouse, 31059 Toulouse, France.
| | - Thierry Levade
- Laboratoire de Biochimie Métabolique, Centre de Référence en Maladies Héréditaires du Métabolisme, Institut Fédératif de Biologie, CHU de Toulouse, 31059 Toulouse cedex 9, France.
- INSERM UMR1037, CRCT (Cancer Research Center of Toulouse), Université Paul Sabatier, 31037 Toulouse, France.
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Rigaud C, Auperin A, Jourdain A, Haouy S, Couec ML, Aladjidi N, Gandemer V, Lambliotte A, Plat G, Landman-Parker J, Michon J, Leblanc T, Patte C, Minard-Colin V. Outcome of relapse in children and adolescents with B-cell non-Hodgkin lymphoma and mature acute leukemia: A report from the French LMB study. Pediatr Blood Cancer 2019; 66:e27873. [PMID: 31207026 DOI: 10.1002/pbc.27873] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 12/17/2018] [Revised: 05/06/2019] [Accepted: 05/21/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION In order to describe relapsed B-cell non-Hodgkin lymphoma and mature acute leukemia in children/adolescents treated with the Lymphomes Malins B (LMB) regimen and their outcome in the rituximab era, relapses in the French LMB2001 study were reviewed. METHODS Between February 2001 and December 2011, 33 patients out of 773 (4.3%) relapsed; 27 had Burkitt lymphoma and six large B-cell histology. Median age at diagnosis was 10.1 years. One patient was initially treated in risk group A, 21 in group B, and 11 in group C. RESULTS Median time to relapse after diagnosis was 4.5 months (range 2.4-13.6). Thirty-two patients received salvage therapy. Twenty-seven received rituximab mainly in addition to high-dose cytarabine and etoposide (n = 18) and/or ifosfamide, carboplatin, and etoposide (n = 7). First-line salvage chemotherapy response rate was 66% with 47% being complete remission (CR). Twenty-one patients received high-dose chemotherapy (HDC) followed by autologous (n = 13) or allogeneic (n = 8) transplant. With a median follow-up of 6.8 years, the 5-year survival rate after relapse was 36.4% (95% confidence interval [CI] 22-53%). Twelve patients were still alive; all but one (group A) received consolidation treatment. Achieving CR before consolidation was significantly associated with better survival, with a 5-year survival rate of 75% (95% CI 46.8-91.1%) for patients in CR before HDC, 33% (95% CI 9.7-70%) for patients in partial remission, and 0% for nonresponders (P = .033). CONCLUSION Survival of children/adolescents with mature B-cell lymphoma/leukemia remains poor after relapse with no apparent improvement with rituximab. Response rates to salvage chemo-immunotherapies are insufficient and new drugs are urgently needed to improve disease control.
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Affiliation(s)
- Charlotte Rigaud
- Department of Pediatric Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Anne Auperin
- Department of Statistics, Gustave Roussy Cancer Campus, Villejuif, France
| | - Anne Jourdain
- Department of Pediatric Oncology and Haematology, University Hospital of Tours, Tours, France
| | - Stephanie Haouy
- Department of Pediatric Oncology and Haematology, University Hospital of Montpellier, Montpellier, France
| | - Marie-Laure Couec
- Department of Pediatric Oncology and Haematology, University Hospital of Nantes, Nantes, France
| | - Nathalie Aladjidi
- Department of Pediatric Oncology and Haematology, University Hospital of Bordeaux, Bordeaux, France
| | - Virginie Gandemer
- Department of Pediatric Oncology and Haematology, University Hospital of Rennes, Rennes, France
| | - Anne Lambliotte
- Department of Pediatric Oncology and Haematology, Centre Oscar Lambret, Lille, France
| | - Geneviève Plat
- Department of Pediatric Oncology and Haematology, University Hospital of Toulouse, Toulouse, France
| | - Judith Landman-Parker
- Department of Pediatric Oncology and Haematology, Hospital Armand Trousseau, Paris, France
| | - Jean Michon
- Department of Pediatric Oncology, Institut Curie, Paris, France
| | - Thierry Leblanc
- Department of Pediatric Oncology and Haematology, Hospital Robert Debré, Paris, France
| | - Catherine Patte
- Department of Pediatric Oncology, Gustave Roussy Cancer Campus, Villejuif, France
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31
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Hofmans M, Suciu S, Ferster A, Van Vlierberghe P, Mazingue F, Sirvent N, Costa V, Yakouben K, Paillard C, Uyttebroeck A, Plantaz D, Plat G, Simon P, Millot F, Poirée M, van der Werff ten Bosch J, Piette C, Minckes O, Rohrlich P, Girard S, Cavé H, Bertrand Y, De Moerloose B. Results of successive EORTC‐CLG 58 881 and 58 951 trials in paediatric T‐cell acute lymphoblastic leukaemia (ALL). Br J Haematol 2019; 186:741-753. [DOI: 10.1111/bjh.15983] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 04/05/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Mattias Hofmans
- Paediatric Haematology‐Oncology and Stem Cell Transplantation Ghent University Hospital GhentBelgium
- Department of Diagnostic Sciences Ghent University GhentBelgium
| | | | - Alina Ferster
- Department of Paediatric Haematology‐Oncology Children's University Hospital Queen FabiolaUniversité Libre de Bruxelles BrusselsBelgium
| | - Pieter Van Vlierberghe
- Cancer Research Institute Ghent GhentBelgium
- Center for Medical Genetics Ghent University Hospital Ghent Belgium
| | - Françoise Mazingue
- Department of Paediatric Haematology‐Oncology Centre Hospitalo‐Universitaire de Lille LilleFrance
| | - Nicolas Sirvent
- Department of Paediatric Haematology‐Oncology Centre Hospitalo‐Universitaire de Montpellier MontpellierFrance
- University Montpellier Montpellier France
| | - Vitor Costa
- Paediatric Department Instituto Português de Oncologia Porto Portugal
| | - Karima Yakouben
- Department of Paediatric Haematology Hôpital Robert DebréAP‐HP ParisFrance
| | - Catherine Paillard
- Department of Paediatric Haematology and Oncology Centre Hospitalo‐Universitaire de Strasbourg Strasbourg France
| | - Anne Uyttebroeck
- Department of Paediatric Haematology‐Oncology University Hospital Gasthuisberg Leuven Belgium
| | - Dominique Plantaz
- Department of Paediatric Oncology University Hospital GrenobleFrance
| | - Geneviève Plat
- Department of Paediatric Haematology‐Oncology Centre Hospitalo‐Universitaire, Hopital Purpan ToulouseFrance
| | - Pauline Simon
- Service Hématologie Oncologie Pédiatrique Centre Hospitalier Régional Universitaire de Besançon BesançonFrance
| | | | - Marilyne Poirée
- Department of Paediatric Haematology‐Oncology Centre Hospitalo‐Universitaire de Nice Nice France
| | | | - Caroline Piette
- Service Universitaire d'Hémato‐Oncologie Pédiatrique Liégeois (SUHOPL)CHR Citadelle Liège Belgium
| | - Odile Minckes
- Department of Paediatric Haematology‐Oncology Centre Hospitalo‐Universitaire de Caen CaenFrance
| | - Pierre Rohrlich
- Department of Paediatric Haematology‐Oncology Centre Hospitalo‐Universitaire de Nice Nice France
| | - Sandrine Girard
- Laboratory of Haematology Institute of Paediatric Haematology and Oncology (IHOP)Hospices Civils de Lyon LyonFrance
| | - Hélène Cavé
- Département de Génétique Assistance Publique des Hôpitaux de Paris (AP‐HP)Hôpital Robert Debré ParisFrance
- INSERM UMR_S1131 Institut de Recherche Saint‐LouisUniversité Paris Diderot ParisFrance
| | - Yves Bertrand
- Institute of Paediatric Haematology and Oncology (IHOP) Haematology UnitHospices Civils de Lyon and Claude Bernard University Lyon France
| | - Barbara De Moerloose
- Paediatric Haematology‐Oncology and Stem Cell Transplantation Ghent University Hospital GhentBelgium
- Cancer Research Institute Ghent GhentBelgium
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Héritier S, Barkaoui MA, Miron J, Thomas C, Moshous D, Lambilliotte A, Mazingue F, Kebaili K, Jeziorski E, Plat G, Aladjidi N, Pacquement H, Galambrun C, Brugières L, Leverger G, Mansuy L, Paillard C, Deville A, Pagnier A, Lutun A, Gillibert-Yvert M, Stephan JL, Cohen-Aubart F, Haroche J, Pellier I, Millot F, Gandemer V, Martin-Duverneuil N, Taly V, Hélias-Rodzewicz Z, Emile JF, Hoang-Xuan K, Idbaih A, Donadieu J. Incidence and risk factors for clinical neurodegenerative Langerhans cell histiocytosis: a longitudinal cohort study. Br J Haematol 2018; 183:608-617. [DOI: 10.1111/bjh.15577] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 07/19/2018] [Indexed: 12/11/2022]
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Ghazavi F, De Moerloose B, Van Loocke W, Wallaert A, Helsmoortel HH, Ferster A, Bakkus M, Plat G, Delabesse E, Uyttebroeck A, Van Nieuwerburgh F, Deforce D, Van Roy N, Speleman F, Benoit Y, Lammens T, Van Vlierberghe P. Unique long non-coding RNA expression signature in ETV6/RUNX1-driven B-cell precursor acute lymphoblastic leukemia. Oncotarget 2018; 7:73769-73780. [PMID: 27650541 PMCID: PMC5342012 DOI: 10.18632/oncotarget.12063] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [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: 05/29/2016] [Accepted: 09/02/2016] [Indexed: 12/19/2022] Open
Abstract
Overwhelming evidence indicates that long non-coding RNAs have essential roles in tumorigenesis. Nevertheless, their role in the molecular pathogenesis of pediatric B-cell precursor acute lymphoblastic leukemia has not been extensively explored. Here, we conducted a comprehensive analysis of the long non-coding RNA transcriptome in ETV6/RUNX1-positive BCP-ALL, one of the most frequent subtypes of pediatric leukemia. First, we used primary leukemia patient samples to identify an ETV6/RUNX1 specific expression signature consisting of 596 lncRNA transcripts. Next, integration of this lncRNA signature with RNA sequencing of BCP-ALL cell lines and lncRNA profiling of an in vitro model system of ETV6/RUNX1 knockdown, revealed that lnc-NKX2-3-1, lnc-TIMM21-5, lnc-ASTN1-1 and lnc-RTN4R-1 are truly regulated by the oncogenic fusion protein. Moreover, sustained inactivation of lnc-RTN4R-1 and lnc-NKX2-3-1 in ETV6/RUNX1 positive cells caused profound changes in gene expression. All together, our study defined a unique lncRNA expression signature associated with ETV6/RUNX1-positive BCP-ALL and identified lnc-RTN4R-1 and lnc-NKX2-3-1 as lncRNAs that might be functionally implicated in the biology of this prevalent subtype of human leukemia.
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Affiliation(s)
- Farzaneh Ghazavi
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium.,Center for Medical Genetics, Department of Paediatrics and Genetics, Ghent University Hospital, Ghent, Belgium
| | - Barbara De Moerloose
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
| | - Wouter Van Loocke
- Center for Medical Genetics, Department of Paediatrics and Genetics, Ghent University Hospital, Ghent, Belgium
| | - Annelynn Wallaert
- Center for Medical Genetics, Department of Paediatrics and Genetics, Ghent University Hospital, Ghent, Belgium
| | - Hetty H Helsmoortel
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium.,Center for Medical Genetics, Department of Paediatrics and Genetics, Ghent University Hospital, Ghent, Belgium
| | - Alina Ferster
- Department of Hemato-Oncology, HUDERF, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Marleen Bakkus
- Department of Hematology, University Hospital Brussels, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Geneviève Plat
- Department of Hematology, Children's Hospital, Toulouse, France
| | - Eric Delabesse
- Department of Hematology, Institut Universitaire de Cancérologie de Toulouse, University Toulouse-III Paul-Sabatier, Toulouse, France
| | - Anne Uyttebroeck
- Department of Pediatric Hemato-Oncology, University Hospitals Leuven, Belgium
| | - Filip Van Nieuwerburgh
- Laboratory of Pharmaceutical Biotechnology, Department of Pharmaceutics, Ghent University, Ghent, Belgium
| | - Dieter Deforce
- Laboratory of Pharmaceutical Biotechnology, Department of Pharmaceutics, Ghent University, Ghent, Belgium
| | - Nadine Van Roy
- Center for Medical Genetics, Department of Paediatrics and Genetics, Ghent University Hospital, Ghent, Belgium
| | - Frank Speleman
- Center for Medical Genetics, Department of Paediatrics and Genetics, Ghent University Hospital, Ghent, Belgium
| | - Yves Benoit
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
| | - Tim Lammens
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
| | - Pieter Van Vlierberghe
- Center for Medical Genetics, Department of Paediatrics and Genetics, Ghent University Hospital, Ghent, Belgium
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34
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Droneau S, Noel-Savina E, Plat G, Murris M, Leborgne-Krams A, Brouchet L, Dahan M, Didier A. L’échographie thoracique du patient transplanté pulmonaire. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.029] [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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35
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Piette C, Suciu S, Clappier E, Bertrand Y, Drunat S, Girard S, Yakouben K, Plat G, Dastugue N, Mazingue F, Grardel N, van Roy N, Uyttebroeck A, Costa V, Minckes O, Sirvent N, Simon P, Lutz P, Ferster A, Pluchart C, Poirée M, Freycon C, Dresse MF, Millot F, Chantrain C, van der Werff Ten Bosch J, Norga K, Gilotay C, Rohrlich PS, Benoit Y, Cavé H. Differential impact of drugs on the outcome of ETV6-RUNX1 positive childhood B-cell precursor acute lymphoblastic leukaemia: results of the EORTC CLG 58881 and 58951 trials. Leukemia 2018; 32:244-248. [PMID: 29064485 DOI: 10.1038/leu.2017.289] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- C Piette
- University Department of Pediatrics, Pediatric Onco-Hematology, CHR Citadelle, Liège, Belgium
| | - S Suciu
- EORTC Headquarters, Brussels, Belgium
| | - E Clappier
- Département de Génétique, Hôpital Robert Debré, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
- Institut Universitaire d'Hématologie, Université Paris Diderot, Paris-Sorbonne-Cité, Paris, France
| | - Y Bertrand
- Department of Pediatric Hematology, IHOP, Hospices Civils de Lyon and Claude Bernard Lyon University, Lyon, France
| | - S Drunat
- Département de Génétique, Hôpital Robert Debré, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
| | - S Girard
- Laboratory of Hematology, East Lyon University Hospital, Hospices Civils de Lyon, Lyon, France
| | - K Yakouben
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Robert Debré, Service d'Immuno-Hématologie pédiatrique, Paris, France
| | - G Plat
- Department of Pediatric Onco-Hematology, Purpan University Hospital, Toulouse, France
| | - N Dastugue
- Department of Pediatric Onco-Hematology, Purpan University Hospital, Toulouse, France
| | - F Mazingue
- Department of Pediatric Hematology-Oncology, Lille University Hospital, Lille, France
| | - N Grardel
- Department of Pediatric Hematology-Oncology, Lille University Hospital, Lille, France
| | - N van Roy
- Center for Medical Genetics, Ghent University, Ghent, Belgium
| | - A Uyttebroeck
- Department of Pediatrics, University Hospital Gasthuisberg, Leuven, Belgium
| | - V Costa
- Department of Pediatrics, Portuguese Oncology Institute, Porto, Portugal
| | - O Minckes
- Department of Pediatric Onco-Hematology, Caen University Hospital, Caen, France
| | - N Sirvent
- Department of Pediatric Onco-Hematology, Montpellier University Hospital, Montpellier, France
| | - P Simon
- Department of Pediatric Onco-Hematology, Besançon University Hospital, Besançon, France
| | - P Lutz
- Department of Hematology, Hautepierre University Hospital, Strasbourg, France
| | - A Ferster
- Department of Pediatric Onco-Hematology, Hôpital Universitaire des Enfants Reine Fabiola (ULB), Brussels, Belgium
| | - C Pluchart
- Department of Pediatric Onco-Hematology, Reims University Hospital, Reims, France
| | - M Poirée
- Department of Pediatric Onco-Hematology, Nice University Hospital, Nice, France
| | - C Freycon
- Department of Pediatric Onco-Hematology, Grenoble University Hospital, Grenoble, France
| | - M-F Dresse
- University Department of Pediatrics, Pediatric Onco-Hematology, CHR Citadelle, Liège, Belgium
| | - F Millot
- Department of Pediatric Onco-Hematology, Poitiers University Hospital, Poitiers, France
| | - C Chantrain
- Department of Pediatrics, Clinique de l'Espérance, CHC, Liège, Belgium
| | | | - K Norga
- Pediatric Onco-Hematology Unit, Antwerp University Hospital, Antwerp, Belgium
| | - C Gilotay
- EORTC Headquarters, Brussels, Belgium
| | - P-S Rohrlich
- Department of Pediatric Onco-Hematology, Nice University Hospital, Nice, France
| | - Y Benoit
- Department of Pediatric Hematology-Oncology, Ghent University Hospital, Ghent, Belgium
| | - H Cavé
- Département de Génétique, Hôpital Robert Debré, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
- Institut Universitaire d'Hématologie, Université Paris Diderot, Paris-Sorbonne-Cité, Paris, France
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36
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Mhanna L, Noel-Savina E, Pontier S, Jaffro M, Guibert N, Hermant C, Plat G, Didier A. [Use of endobronchial ultrasound in the management of cryptogenic haemoptysis]. Rev Mal Respir 2017; 34:770-773. [PMID: 28867308 DOI: 10.1016/j.rmr.2016.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 12/16/2016] [Indexed: 11/17/2022]
Abstract
Currently about 50% of cases of haemoptysis are thought to be cryptogenic. Haemorrhage from the pulmonary arterial system is rare and usually due to aneurysms or pseudoaneurysms, the radiological diagnosis of which is often difficult. We report here the case of a patient admitted with a heavy haemoptysis in whom the thoracic CT scan did not reveal the diagnosis. Bronchoscopy with endobronchial ultrasound showed a vascular malformation of a branch of the pulmonary artery allowing a radiological embolisation. This case underlines the importance of bronchoscopy and the role of ultrasound in the diagnosis of haemoptysis, considered ideopathic, complicating vascular malformations.
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Affiliation(s)
- L Mhanna
- Pôle des voies respiratoires, service de pneumologie-allergologie, hôpital Larrey, CHU de Toulouse, université Paul-Sabatier, chemin de Pouvourville, 31059 Toulouse cedex, France
| | - E Noel-Savina
- Pôle des voies respiratoires, service de pneumologie-allergologie, hôpital Larrey, CHU de Toulouse, université Paul-Sabatier, chemin de Pouvourville, 31059 Toulouse cedex, France.
| | - S Pontier
- Pôle des voies respiratoires, service de pneumologie-allergologie, hôpital Larrey, CHU de Toulouse, université Paul-Sabatier, chemin de Pouvourville, 31059 Toulouse cedex, France
| | - M Jaffro
- Service de radiologie, centre hospitalier universitaire, université Paul-Sabatier, 31000 Toulouse, France
| | - N Guibert
- Pôle des voies respiratoires, service de pneumologie-allergologie, hôpital Larrey, CHU de Toulouse, université Paul-Sabatier, chemin de Pouvourville, 31059 Toulouse cedex, France
| | - C Hermant
- Pôle des voies respiratoires, service de pneumologie-allergologie, hôpital Larrey, CHU de Toulouse, université Paul-Sabatier, chemin de Pouvourville, 31059 Toulouse cedex, France
| | - G Plat
- Pôle des voies respiratoires, service de pneumologie-allergologie, hôpital Larrey, CHU de Toulouse, université Paul-Sabatier, chemin de Pouvourville, 31059 Toulouse cedex, France
| | - A Didier
- Pôle des voies respiratoires, service de pneumologie-allergologie, hôpital Larrey, CHU de Toulouse, université Paul-Sabatier, chemin de Pouvourville, 31059 Toulouse cedex, France
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37
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Mondelaers V, Suciu S, De Moerloose B, Ferster A, Mazingue F, Plat G, Yakouben K, Uyttebroeck A, Lutz P, Costa V, Sirvent N, Plouvier E, Munzer M, Poirée M, Minckes O, Millot F, Plantaz D, Maes P, Hoyoux C, Cavé H, Rohrlich P, Bertrand Y, Benoit Y. Prolonged versus standard native E. coli asparaginase therapy in childhood acute lymphoblastic leukemia and non-Hodgkin lymphoma: final results of the EORTC-CLG randomized phase III trial 58951. Haematologica 2017; 102:1727-1738. [PMID: 28751566 PMCID: PMC5622857 DOI: 10.3324/haematol.2017.165845] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 02/06/2017] [Accepted: 07/21/2017] [Indexed: 12/05/2022] Open
Abstract
Asparaginase is an essential component of combination chemotherapy for childhood acute lymphoblastic leukemia and non-Hodgkin lymphoma. The value of asparaginase was further addressed in a group of non-very high-risk patients by comparing prolonged (long-asparaginase) versus standard (short-asparaginase) native E. coli asparaginase treatment in a randomized part of the phase III 58951 trial of the European Organization for Research and Treatment of Cancer Children’s Leukemia Group. The main endpoint was disease-free survival. Overall, 1,552 patients were randomly assigned to long-asparaginase (775 patients) or short-asparaginase (777 patients). Patients with grade ≥2 allergy to native E. coli asparaginase were switched to equivalent doses of Erwinia or pegylated E. coli asparaginase. The 8-year disease-free survival rate (±standard error) was 87.0±1.3% in the long-asparaginase group and 84.4±1.4% in the short-asparaginase group (hazard ratio: 0.87; P=0.33) and the 8-year overall survival rate was 92.6±1.0% and 91.3±1.2% respectively (hazard ratio: 0.89; P=0.53). An exploratory analysis suggested that the impact of long-asparaginase was beneficial in the National Cancer Institute standard-risk group with regards to disease-free survival (hazard ratio: 0.70; P=0.057), but far less so with regards to overall survival (hazard ratio: 0.89). The incidences of grade 3–4 infection during consolidation (25.2% versus 14.4%) and late intensification (22.6% versus 15.9%) and the incidence of grade 2–4 allergy were higher in the long-asparaginase arm (30% versus 21%). Prolonged native E. coli asparaginase therapy in consolidation and late intensification for our non-very high-risk patients did not improve overall outcome but led to an increase in infections and allergy. This trial was registered at www.clinicaltrials.gov as #NCT00003728.
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Affiliation(s)
- Veerle Mondelaers
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent University, Belgium
| | | | - Barbara De Moerloose
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent University, Belgium
| | - Alina Ferster
- Department of Pediatric Hematology-Oncology, Children's University Hospital Queen Fabiola, Université Libre de Bruxelles (ULB), Belgium
| | | | - Geneviève Plat
- Department of Pediatric Hematology-Oncology, CHU-Hopital Purpan, Toulouse, France
| | - Karima Yakouben
- Department of Pediatric Hematology, Robert Debré Hospital, AP-HP, Paris, France
| | - Anne Uyttebroeck
- Department of Pediatric Hematology-Oncology, University Hospital Gasthuisberg, Leuven, Belgium
| | - Patrick Lutz
- Department of Pediatric Hematology-Oncology, University Hospital Hautepierre, Strasbourg, France
| | - Vitor Costa
- Department of Pediatrics, Portuguese Oncology Institute, Porto, Portugal
| | - Nicolas Sirvent
- Department of Pediatric Hematology-Oncology, CHU, Montpellier, France
| | - Emmanuel Plouvier
- Pediatric Hematology Unit, CHU Jean Minjoz Hospital, Besançon, France
| | - Martine Munzer
- Department of Pediatric Hematology-Oncology, American Memorial Hospital, Reims, France
| | - Maryline Poirée
- Department of Pediatric Hematology-Oncology, CHU Lenval, Nice, France
| | - Odile Minckes
- Department of Pediatric Hematology-Oncology, CHU, Caen, France
| | - Frédéric Millot
- Pediatric Oncology Unit, University Hospital, Poitiers, France
| | - Dominique Plantaz
- Department of Pediatric Oncology, University Hospital, Grenoble, France
| | - Philip Maes
- Department of Pediatrics, University Hospital Antwerp, Belgium
| | - Claire Hoyoux
- Department of Pediatrics, CHR de la Citadelle, Liège, Belgium
| | - Hélène Cavé
- Department of Genetics, Assistance Publique des Hôpitaux de Paris (AP-HP), Robert Debré Hospital, Paris, France.,INSERM UMR 1131, University Institute of Hematology, University Paris Diderot, Paris Sorbonne Cité, France
| | - Pierre Rohrlich
- Department of Pediatric Hematology-Oncology, CHU Lenval, Nice, France
| | - Yves Bertrand
- Institute of Pediatric Hematology and Oncology (IHOP), Hospices Civils de Lyon, and University Lyon 1, France
| | - Yves Benoit
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent University, Belgium
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38
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Héritier S, Hélias-Rodzewicz Z, Lapillonne H, Terrones N, Garrigou S, Normand C, Barkaoui MA, Miron J, Plat G, Aladjidi N, Pagnier A, Deville A, Gillibert-Yvert M, Moshous D, Lefèvre-Utile A, Lutun A, Paillard C, Thomas C, Jeziorski E, Nizard P, Taly V, Emile JF, Donadieu J. Circulating cell-free BRAF
V600E
as a biomarker in children with Langerhans cell histiocytosis. Br J Haematol 2017; 178:457-467. [DOI: 10.1111/bjh.14695] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 02/06/2017] [Indexed: 01/05/2023]
Affiliation(s)
- Sébastien Héritier
- French Reference Centre for Langerhans Cell Histiocytosis; Trousseau Hospital; Paris France
- EA4340; UVSQ, Université Paris-Saclay; Boulogne-Billancourt France
- Department of Paediatric Haematology and Oncology; Trousseau Hospital; Assistance Publique-Hôpitaux de Paris; Paris France
| | - Zofia Hélias-Rodzewicz
- EA4340; UVSQ, Université Paris-Saclay; Boulogne-Billancourt France
- Pathology Department; Ambroise Paré Hospital; Assistance Publique-Hôpitaux de Paris; Boulogne-Billancourt France
| | - Hélène Lapillonne
- Laboratory of Haematology; Trousseau Hospital; Assistance Publique-Hôpitaux de Paris; Paris France
| | - Nathalie Terrones
- EA4340; UVSQ, Université Paris-Saclay; Boulogne-Billancourt France
- Pathology Department; Ambroise Paré Hospital; Assistance Publique-Hôpitaux de Paris; Boulogne-Billancourt France
| | - Sonia Garrigou
- INSERM UMR-S1147; CNRS SNC 5014; Université Paris Sorbonne Cité; Paris France
| | - Corinne Normand
- INSERM UMR-S1147; CNRS SNC 5014; Université Paris Sorbonne Cité; Paris France
| | - Mohamed-Aziz Barkaoui
- French Reference Centre for Langerhans Cell Histiocytosis; Trousseau Hospital; Paris France
| | - Jean Miron
- French Reference Centre for Langerhans Cell Histiocytosis; Trousseau Hospital; Paris France
| | - Geneviève Plat
- Department of Paediatric Haematology and Oncology; Centre Hospitalo-Universitaire de Toulouse; Toulouse France
| | - Nathalie Aladjidi
- Department of Paediatric Haematology and Oncology; Centre Hospitalo-Universitaire de Bordeaux; Bordeaux France
| | - Anne Pagnier
- Department of Paediatric Haematology and Oncology; Centre Hospitalo-Universitaire de Grenoble; Grenoble France
| | - Anne Deville
- Department of Paediatric Haematology and Oncology; Centre Hospitalo-Universitaire de Nice; Nice France
| | - Marion Gillibert-Yvert
- Department of Paediatric Haematology and Oncology; Centre Hospitalo-Universitaire de Tours; Tours France
| | - Despina Moshous
- Department of Paediatric Immunology; Haematology and Rheumatology; Necker Hospital, Assistance Publique-Hôpitaux de Paris; Paris France
| | - Alain Lefèvre-Utile
- Department of Paediatric Immunology; Haematology and Rheumatology; Necker Hospital, Assistance Publique-Hôpitaux de Paris; Paris France
| | - Anne Lutun
- Department of Paediatric Haematology and Oncology; Centre Hospitalo-Universitaire d'Amiens; Amiens France
| | - Catherine Paillard
- Department of Paediatric Haematology and Oncology; Centre Hospitalo-Universitaire de Strasbourg; Strasbourg France
| | - Caroline Thomas
- Department of Paediatric Haematology and Oncology; Centre Hospitalo-Universitaire de Nantes; Nantes France
| | - Eric Jeziorski
- Department of Paediatric; Hôpital Arnaud de Villeneuve; Montpellier France
| | - Philippe Nizard
- INSERM UMR-S1147; CNRS SNC 5014; Université Paris Sorbonne Cité; Paris France
| | - Valérie Taly
- INSERM UMR-S1147; CNRS SNC 5014; Université Paris Sorbonne Cité; Paris France
| | - Jean-François Emile
- EA4340; UVSQ, Université Paris-Saclay; Boulogne-Billancourt France
- Pathology Department; Ambroise Paré Hospital; Assistance Publique-Hôpitaux de Paris; Boulogne-Billancourt France
| | - Jean Donadieu
- French Reference Centre for Langerhans Cell Histiocytosis; Trousseau Hospital; Paris France
- EA4340; UVSQ, Université Paris-Saclay; Boulogne-Billancourt France
- Department of Paediatric Haematology and Oncology; Trousseau Hospital; Assistance Publique-Hôpitaux de Paris; Paris France
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39
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Alloin AL, Leverger G, Dalle JH, Galambrun C, Bertrand Y, Baruchel A, Auvrignon A, Gandemer V, Ragu C, Loundou A, Bilhou-Nabera C, Lafage-Pochitaloff M, Dastugue N, Nelken B, Jubert C, Rialland F, Plat G, Pochon C, Vannier JP, Rohrlich PS, Kanold J, Lutz P, Sirvent A, Oudin C, Cuccuini W, Michel G. Cytogenetics and outcome of allogeneic transplantation in first remission of acute myeloid leukemia: the French pediatric experience. Bone Marrow Transplant 2016; 52:516-521. [PMID: 27941778 DOI: 10.1038/bmt.2016.293] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 09/14/2016] [Accepted: 09/20/2016] [Indexed: 01/04/2023]
Abstract
We analyzed the impact of cytogenetics on 193 children enrolled in two successive French trials (LAME89/91 and ELAM02), who received hematopoietic stem cell transplantation during CR1. Detailed karyotype was available for 66/74 (89%) in LAME89/91 and 118/119 (99%) in ELAM02. Several karyotype and transplant characteristics differed according to therapeutic protocol: unfavorable karyotypes were more frequent in ELAM02 (36% vs 18%), pretransplant chemotherapy included high-dose cytarabine in ELAM02 and not in LAME89/91, IV replaced oral busulfan in the conditioning regimen, methotrexate was removed from post-transplant immunosuppression, and matched unrelated donor and cord blood transplantation were introduced. Five-year overall survival (OS) was 78.2% in LAME89 and 81.4% in ELAM02. OS was significantly lower for the unfavorable cytogenetic risk group in LAME89/91 when compared with intermediate and favorable groups (50% vs 90.6 and 86.4%, P=0.001). This difference was no longer apparent in ELAM02 (80.9% vs 71.3% and 5/5, respectively). Survival improvement for children with unfavorable karyotype was statistically significant (P=0.026) and was due to decrease in relapse risk. Five-year transplantation-related mortality was 6.75% in LAME89/91. In ELAM02, it was 3.2% for patients with a sibling donor and 10.9% with an unrelated donor or cord blood. We conclude that the outcome of children with unfavorable karyotype transplanted in CR1 has improved.
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Affiliation(s)
- A-L Alloin
- Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France
| | - G Leverger
- Department of Pediatric Hematology and Oncology, AP-HP, GH HUEP, Trousseau Hospital, Paris, France.,UPMC University Paris 6, Paris, France
| | - J-H Dalle
- Department of Pediatric Hematology and Oncology, Robert Debré Hospital, Paris, France
| | - C Galambrun
- Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France
| | - Y Bertrand
- Department of Pediatric Hematology and Oncology, University Hospital of Lyon, Lyon, France
| | - A Baruchel
- Department of Pediatric Hematology and Oncology, Robert Debré Hospital, Paris, France
| | - A Auvrignon
- Department of Pediatric Hematology and Oncology, AP-HP, GH HUEP, Trousseau Hospital, Paris, France
| | - V Gandemer
- Department of Pediatric Hematology and Oncology, University Hospital of Rennes, Rennes, France
| | - C Ragu
- Department of Pediatric Hematology and Oncology, AP-HP, GH HUEP, Trousseau Hospital, Paris, France
| | - A Loundou
- Research Unit EA3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France
| | | | - M Lafage-Pochitaloff
- Department of Genetics, Timone Enfants Hospital and Aix-Marseille University, Marseille, France
| | - N Dastugue
- Department of Genetics, University hospital of Toulouse, Toulouse, France
| | - B Nelken
- CHU Lille, Department of Pediatric Hematology and Oncology, Lille, France
| | - C Jubert
- Department of Pediatric Hematology and Oncology, University Hospital of Bordeaux, Bordeaux, France
| | - F Rialland
- Department of Pediatric Hematology and Oncology, University Hospital of Nantes, Nantes, France
| | - G Plat
- Department of Pediatric Hematology and Oncology, University Hospital of Toulouse, Toulouse, France
| | - C Pochon
- Department of Pediatric Hematology and Oncology, Hôpital d'Enfants de Brabois, Vandoeuvre Les Nancy, France
| | - J-P Vannier
- Department of Pediatric Hematology and Oncology, University Hospital of Rouen, Rouen, France
| | - P-S Rohrlich
- Department of Pediatric Hematology and Oncology, University Hospital L'Archet, Nice, France
| | - J Kanold
- Department of Pediatric Hematology and Oncology, CIC Inserm 501, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - P Lutz
- Department of Pediatric Hematology and Oncology, Hospital University, Strasbourg, France
| | - A Sirvent
- Department of Pediatric Hematology and Oncology, University Hospital, Montpellier, France
| | - C Oudin
- Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France.,Research Unit EA3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France
| | - W Cuccuini
- Department of Cytogenetics, Saint-Louis Hospital, Paris, France
| | - G Michel
- Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France.,Research Unit EA3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France
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40
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Visentin S, Auquier P, Bertrand Y, Baruchel A, Tabone MD, Pochon C, Jubert C, Poirée M, Gandemer V, Sirvent A, Bonneau J, Paillard C, Freycon C, Kanold J, Villes V, Berbis J, Oudin C, Galambrun C, Pellier I, Plat G, Chambost H, Leverger G, Dalle JH, Michel G. The Impact of Donor Type on Long-Term Health Status and Quality of Life after Allogeneic Hematopoietic Stem Cell Transplantation for Childhood Acute Leukemia: A Leucémie de l'Enfant et de L'Adolescent Study. Biol Blood Marrow Transplant 2016; 22:2003-2010. [PMID: 27522039 DOI: 10.1016/j.bbmt.2016.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 08/03/2016] [Indexed: 01/01/2023]
Abstract
We compared the long-term impact of donor type (sibling donor [SD] versus matched unrelated donor [MUD] or umbilical cord blood [UCB]) on late side effects and quality of life (QoL) in childhood acute leukemia survivors treated with hematopoietic stem cell transplantation. We included 314 patients who underwent transplantation from 1997 to 2012 and were enrolled in the multicenter French Leucémie de l'Enfant et de L'Adolescent ("Leukemia in Children and Adolescents") cohort. More than one-third of the patients were adults at last visit; mean follow-up duration was 6.2 years. At least 1 late effect was observed in 284 of 314 patients (90.4%). The average number of adverse late effects was 2.1 ± .1, 2.4 ± .2, and 2.4 ± .2 after SD, MUD, and UCB transplantation, respectively. In a multivariate analysis, considering the SD group as the reference, we did not detect an impact of donor type for most sequelae, with the exception of increased risk of major growth failure after MUD transplantation (odds ratio [OR], 2.42) and elevated risk of osteonecrosis after UCB transplantation (OR, 4.15). The adults and children's parents reported comparable QoL among the 3 groups. Adult patient QoL scores were lower than age- and sex-matched French reference scores for almost all dimensions. We conclude that although these patients are heavily burdened by long-term complications, donor type had a very limited impact on their long-term health status and QoL.
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Affiliation(s)
- Sandrine Visentin
- Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France.
| | - Pascal Auquier
- Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, France
| | - Yves Bertrand
- Department of Pediatric Hematology and Oncology, University Hospital of Lyon, France
| | - André Baruchel
- Pediatric Hematology Department, Robert Debré Hospital, Paris, France
| | | | - Cécile Pochon
- Department of Pediatric Onco-Haematology, Hôpital d'Enfants de Brabois, Vandoeuvre Les Nancy, France
| | - Charlotte Jubert
- Department of Pediatric Hematology and Oncology, University Hospital of Bordeaux, France
| | - Maryline Poirée
- Pediatric Hematology and Oncology Department, University Hospital L'Archet, Nice, France
| | - Virginie Gandemer
- Department of Pediatric Hematology and Oncology, University Hospital of Rennes, France
| | - Anne Sirvent
- Pediatric Hematology and Oncology Department, University Hospital, Montpellier, France
| | - Jacinthe Bonneau
- Department of Pediatric Hematology and Oncology, University Hospital of Rennes, France
| | - Catherine Paillard
- Department of Pediatric Hematology-oncology, University Hospital, Strasbourg, France
| | - Claire Freycon
- Department of Pediatric Hematology-Oncology, University Hospital of Grenoble, France
| | - Justyna Kanold
- Department of Pediatric Hematology and Oncology, CIC Inserm 501, University Hospital of Clermont-Ferrand, France
| | - Virginie Villes
- Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, France
| | - Julie Berbis
- Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, France
| | - Claire Oudin
- Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France; Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, France
| | - Claire Galambrun
- Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France
| | - Isabelle Pellier
- Pediatric Hematology and Oncology Department, University Hospital of Angers, Angers, France
| | - Geneviève Plat
- Department of Pediatric Onco-Hematology, CHU-Hospital Purpan, Toulouse, France
| | - Hervé Chambost
- Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France
| | - Guy Leverger
- Pediatric Hematology Department, Trousseau Hospital, Paris, France
| | - Jean-Hugues Dalle
- Pediatric Hematology Department, Robert Debré Hospital, Paris, France
| | - Gérard Michel
- Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France; Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, France
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41
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Héritier S, Emile JF, Barkaoui MA, Thomas C, Fraitag S, Boudjemaa S, Renaud F, Moreau A, Peuchmaur M, Chassagne-Clément C, Dijoud F, Rigau V, Moshous D, Lambilliotte A, Mazingue F, Kebaili K, Miron J, Jeziorski E, Plat G, Aladjidi N, Ferster A, Pacquement H, Galambrun C, Brugières L, Leverger G, Mansuy L, Paillard C, Deville A, Armari-Alla C, Lutun A, Gillibert-Yvert M, Stephan JL, Cohen-Aubart F, Haroche J, Pellier I, Millot F, Lescoeur B, Gandemer V, Bodemer C, Lacave R, Hélias-Rodzewicz Z, Taly V, Geissmann F, Donadieu J. BRAF Mutation Correlates With High-Risk Langerhans Cell Histiocytosis and Increased Resistance to First-Line Therapy. J Clin Oncol 2016; 34:3023-30. [PMID: 27382093 DOI: 10.1200/jco.2015.65.9508] [Citation(s) in RCA: 198] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Langerhans cell histiocytosis (LCH) is an inflammatory myeloid neoplasia with a broad spectrum of clinical manifestations and outcomes in children. The somatic BRAF(V600E) mutation occurs frequently, but clinical significance remains to be determined. PATIENTS AND METHODS BRAF(V600E) mutation was investigated in a French LCH cohort. We analyzed associations between mutation status and clinical presentation, extent of disease, reactivation rate, response to therapy, and long-term permanent sequelae. RESULTS Among 315 patients with successfully determined BRAF status, 173 (54.6%) carried a BRAF(V600E) mutation. Patients with BRAF(V600E) manifested more severe disease than did those with wild-type BRAF. Patients with BRAF(V600E) comprised 87.8% of patients (43 of 49) with multisystem LCH with risk organ involvement (liver, spleen, hematology), 68.6% of patients (35 of 51) with multisystem LCH without risk organ involvement, 43.9% of patients (86 of 196) with single-system LCH, and 42.1% of patients (8 of 19) with lung-involved LCH (P < .001). BRAF(V600E) mutation was also associated with organ involvement that could lead to permanent, irreversible damage, such as neurologic (75%) and pituitary (72.9%) injuries. Compared with patients with wild-type BRAF, patients with BRAF(V600E) more commonly displayed resistance to combined vinblastine and corticosteroid therapy (21.9% v 3.3%; P = .001), showed a higher reactivation rate (5-year reactivation rate, 42.8% v 28.1%; P = .006), and had more permanent, long-term consequences from disease or treatment (27.9% v 12.6%; P = .001). CONCLUSION In children with LCH, BRAF(V600E) mutation was associated with high-risk features, permanent injury, and poor short-term response to chemotherapy. Further population-based studies should be undertaken to confirm our observations and to assess the impact of BRAF inhibitors for this subgroup of patients who may benefit from targeted therapy.
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Affiliation(s)
- Sébastien Héritier
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Jean-François Emile
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Mohamed-Aziz Barkaoui
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Caroline Thomas
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Sylvie Fraitag
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Sabah Boudjemaa
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Florence Renaud
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Anne Moreau
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Michel Peuchmaur
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Catherine Chassagne-Clément
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Frédérique Dijoud
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Valérie Rigau
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Despina Moshous
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Anne Lambilliotte
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Françoise Mazingue
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Kamila Kebaili
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Jean Miron
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Eric Jeziorski
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Geneviève Plat
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Nathalie Aladjidi
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Alina Ferster
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Hélène Pacquement
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Claire Galambrun
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Laurence Brugières
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Guy Leverger
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Ludovic Mansuy
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Catherine Paillard
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Anne Deville
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Corinne Armari-Alla
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Anne Lutun
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Marion Gillibert-Yvert
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Jean-Louis Stephan
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Fleur Cohen-Aubart
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Julien Haroche
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Isabelle Pellier
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Frédéric Millot
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Brigitte Lescoeur
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Virginie Gandemer
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Christine Bodemer
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Roger Lacave
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Zofia Hélias-Rodzewicz
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Valérie Taly
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Frédéric Geissmann
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Jean Donadieu
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
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Rigaud C, Barkaoui MA, Thomas C, Bertrand Y, Lambilliotte A, Miron J, Aladjidi N, Plat G, Jeziorski E, Galambrun C, Mansuy L, Lutz P, Deville A, Armari-Alla C, Reguerre Y, Fraitag S, Coulomb A, Gandemer V, Leboulanger N, Moshous D, Hoang-Xuan K, Tazi A, Heritier S, Emile JF, Donadieu J. Langerhans cell histiocytosis: therapeutic strategy and outcome in a 30-year nationwide cohort of 1478 patients under 18 years of age. Br J Haematol 2016; 174:887-98. [PMID: 27273725 DOI: 10.1111/bjh.14140] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [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: 01/13/2016] [Accepted: 03/20/2016] [Indexed: 10/21/2022]
Abstract
The French national cohort of children with Langerhans cell histiocytosis (LCH) has included 1478 patients since it was established in 1983. LCH therapeutic strategies substantially changed in 1998, so we have divided the cohort into two 15-year periods. Starting in 1998, therapy duration increased from 6 to 12 months, repeated induction therapy was performed in cases showing a poor response to the first induction with vinblastine and steroids, and refractory disease in a risk organ (RO+) was treated with cladribine and cytarabine. A total of 483 (33%) patients were enrolled before 1998, and 995 (67%) after 1998. Five-year survival was 96·6% (95% confidence interval: 95·4-97·5%) overall, improving from 92% pre-1998 to 99% post-1998 (P < 0·001 adjusted to disease extent). This change was supported by an increase in 5-year survival from 60% to 92% in the RO+ group. Survival was particularly associated with cladribine and cytarabine among refractory RO+ patients. Disease reactivation was slightly less frequent after 1998, due to better enrolment of single-system patients, extended therapy duration, and more efficient second-line therapy. The crude rates of endocrine and neurological sequelae (the most frequent sequelae) appeared to improve over time, but this difference was not observed when the analysis was stratified by disease extent.
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Affiliation(s)
- Charlotte Rigaud
- Registre français des histiocytoses, Service d'Hémato-oncologie Pédiatrique Hôpital Trousseau, AP-HP, Paris, France.,Service de Pédiatrie Institut Gustave Roussy, IGR, Villejuif
| | - Mohamed A Barkaoui
- Registre français des histiocytoses, Service d'Hémato-oncologie Pédiatrique Hôpital Trousseau, AP-HP, Paris, France
| | - Caroline Thomas
- Service d'hémato-oncologie pédiatrique, Centre Hospitalo-Universitaire de Nantes, Nantes, France
| | - Yves Bertrand
- Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France
| | - Anne Lambilliotte
- Unité d'Hémato-oncologie Pédiatrique, Centre Hospitalo-Universitaire de Lille, Lille, France
| | - Jean Miron
- Registre français des histiocytoses, Service d'Hémato-oncologie Pédiatrique Hôpital Trousseau, AP-HP, Paris, France
| | - Nathalie Aladjidi
- CIC 1401, Inserm CICP, Hopital Pellegrin-enfant, CEREVANCE, CHU de Bordeaux, Bordeaux, France
| | - Geneviève Plat
- Service d'hémato-oncologie pédiatrique, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France
| | - Eric Jeziorski
- Service d'hémato et d'oncologie pédiatrique, Centre Hospitalo-Universitaire de Montpellier, Montpellier, France
| | - Claire Galambrun
- Service d'Hématologie Oncologie pédiatrique, Centre Hospitalo-Universitaire de Marseille, Marseille, France
| | - Ludovic Mansuy
- Medecine Infantile 2, Centre Hospitalo-Universitaire de Nancy, Nancy, France
| | - Patrick Lutz
- Service d'hémato-oncologie pédiatrique, Centre Hospitalo-Universitaire de Strasbourg, Strasbourg, France
| | - Anne Deville
- Service d'hémato-oncologie pédiatrique, Centre Hospitalo-Universitaire de Nice, Nice, France
| | - Corinne Armari-Alla
- Service d'hémato-oncologie pédiatrique, Centre Hospitalo-Universitaire de Grenoble, La Tronche, France
| | - Yves Reguerre
- Service d'hémato-oncologie pédiatrique, Centre Hospitalo-Universitaire de la Réunion Hôpital Felix Guyon, Saint denis, La Réunion, France
| | - Sylvie Fraitag
- Service d'Anatomopathologie, Hôpital Necker Enfants, AP-HP, Paris, France
| | - Aurore Coulomb
- Service d'Anatomopathologie, Hopital Trousseau, Paris, France
| | - Virginie Gandemer
- Service d'Hématologie pédiatrique, Centre Hospitalo-Universitaire de Rennes, Rennes, France
| | - Nicolas Leboulanger
- Service d'Otorhinolaryngologie et Chirurgie Cervicofaciale, Hôpital Necker Enfants Malades, AP-HP, Paris, France
| | - Despina Moshous
- Unité d'Immuno-hématologie pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Paris, France
| | - Khe Hoang-Xuan
- Service de Neurologie, Groupe hospitalier Pitié Salpêtrière-Charles Foix, AP-HP, Sorbonne Universités - UPMC, Paris, France
| | - Abdellatif Tazi
- APHP Service de Pneumologie Centre de référence des histiocytoses Hôpital Saint Louis, Paris, France
| | - Sébastien Heritier
- Registre français des histiocytoses, Service d'Hémato-oncologie Pédiatrique Hôpital Trousseau, AP-HP, Paris, France
| | - Jean-François Emile
- Service de pathologie, Hôpital Ambroise Paré, UVSQ, Université Paris-Saclay, AP-HP, Boulogne, France
| | - Jean Donadieu
- Registre français des histiocytoses, Service d'Hémato-oncologie Pédiatrique Hôpital Trousseau, AP-HP, Paris, France
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Mellgren K, Attarbaschi A, Abla O, Alexander S, Bomken S, Bubanska E, Chiang A, Csóka M, Fedorova A, Kabickova E, Kapuscinska-Kemblowska L, Kobayashi R, Krenova Z, Meyer-Wentrup F, Miakova N, Pillon M, Plat G, Uyttebroeck A, Williams D, Wróbel G, Kontny U. Non-anaplastic peripheral T cell lymphoma in children and adolescents-an international review of 143 cases. Ann Hematol 2016; 95:1295-305. [PMID: 27270301 DOI: 10.1007/s00277-016-2722-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [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: 04/07/2016] [Accepted: 05/31/2016] [Indexed: 01/18/2023]
Abstract
Peripheral T cell lymphomas (PTCL) are rare in children and adolescents, and data about outcome and treatment results are scarce. The present study is a joint, international, retrospective analysis of 143 reported cases of non-anaplastic PTCL in patients <19 years of age, with a focus on treatment and outcome features. One hundred forty-three patients, between 0.3 and 18.7 years old, diagnosed between 2000 and 2015 were included in the study. PTCL not otherwise specified was the largest subgroup, followed by extranodal NK/T cell lymphoma, hepatosplenic T cell lymphoma (HS TCL), and subcutaneous panniculitis-like T cell lymphoma (SP TCL). Probability of overall survival (pOS) at 5 years for the whole group was 0.56 ± 0.05, and probability of event-free survival was (pEFS) 0.45 ± 0.05. Patients with SP TCL had a good outcome with 5-year pOS of 0.78 ± 0.1 while patients with HS TCL were reported with 5-year pOS of only 0.13 ± 0.12. Twenty-five percent of the patients were reported to have a pre-existing condition, and this group had a dismal outcome with 5-year pOS of 0.29 ± 0.09. The distribution of non-anaplastic PTCL subtypes in pediatric and adolescent patients differs from what is reported in adult patients. Overall outcome depends on the subtype with some doing better than others. Pre-existing conditions are frequent and associated with poor outcomes. There is a clear need for subtype-based treatment recommendations for children and adolescents with PTCL.
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Affiliation(s)
- K Mellgren
- Department of Pediatric Hematology and Oncology, The Queen Silvia's Hospital for Children, Rondvägen 10, 41685, Göteborg, Sweden.
| | - A Attarbaschi
- Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - O Abla
- Department of Pediatrics, Division of Hematology and Oncology, Hospital for Sick Children, Toronto, ON, Canada
| | - S Alexander
- Department of Pediatrics, Division of Hematology and Oncology, Hospital for Sick Children, Toronto, ON, Canada
| | - S Bomken
- Department of Paediatric Haematology and Oncology, Great North Children's Hospital, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - E Bubanska
- Department of Pediatric Oncology and Hematology, University Children's Hospital, Banska Bystrica, Slovakia
| | - A Chiang
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - M Csóka
- Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary
| | - A Fedorova
- Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus
| | - E Kabickova
- Pediatric Hematology and Oncology, Charles University and University Hospital Motol, Prague, Czech Republic
| | | | - R Kobayashi
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Z Krenova
- Pediatric Oncology and Hematology, University Hospital, Brno, Czech Republic
| | - F Meyer-Wentrup
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - N Miakova
- Pediatric Hematology and Oncology, Federal Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - M Pillon
- Pediatric Hematology and Oncology, University of Padova, Padova, Italy
| | - G Plat
- Department of Pediatric Oncology, Hôpital des Enfants, Toulouse, France
| | - A Uyttebroeck
- Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
| | - D Williams
- Pediatric Hematology and Oncology, Addbrooke's Hospital, Cambridge University Hospitals Foundation Trust, Cambridge, UK
| | - G Wróbel
- Bone Marrow Transplantation and Pediatric Hematology and Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - U Kontny
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, University Medical Center, Aachen, Germany
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44
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Ghazavi F, Clappier E, Lammens T, Suciu S, Caye A, Zegrari S, Bakkus M, Grardel N, Benoit Y, Bertrand Y, Minckes O, Costa V, Ferster A, Mazingue F, Plat G, Plouvier E, Poirée M, Uyttebroeck A, van der Werff-Ten Bosch J, Yakouben K, Helsmoortel H, Meul M, Van Roy N, Philippé J, Speleman F, Cavé H, Van Vlierberghe P, De Moerloose B. CD200/BTLA deletions in pediatric precursor B-cell acute lymphoblastic leukemia treated according to the EORTC-CLG 58951 protocol. Haematologica 2015; 100:1311-9. [PMID: 26137961 DOI: 10.3324/haematol.2015.126953] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 06/23/2015] [Indexed: 12/22/2022] Open
Abstract
DNA copy number analysis has been instrumental for the identification of genetic alterations in B-cell precursor acute lymphoblastic leukemia. Notably, some of these genetic defects have been associated with poor treatment outcome and might be relevant for future risk stratification. In this study, we characterized recurrent deletions of CD200 and BTLA genes, mediated by recombination-activating genes, and used breakpoint-specific polymerase chain reaction assay to screen a cohort of 1154 cases of B-cell precursor acute lymphoblastic leukemia uniformly treated according to the EORTC-CLG 58951 protocol. CD200/BTLA deletions were identified in 56 of the patients (4.8%) and were associated with an inferior 8-year event free survival in this treatment protocol [70.2% ± 1.2% for patients with deletions versus 83.5% ± 6.4% for non-deleted cases (hazard ratio 2.02; 95% confidence interval 1.23-3.32; P=0.005)]. Genetically, CD200/BTLA deletions were strongly associated with ETV6-RUNX1-positive leukemias (P<0.0001), but were also identified in patients who did not have any genetic abnormality that is currently used for risk stratification. Within the latter population of patients, the presence of CD200/BTLA deletions was associated with inferior event-free survival and overall survival. Moreover, the multivariate Cox model indicated that these deletions had independent prognostic impact on event-free survival when adjusting for conventional risk criteria. All together, these findings further underscore the rationale for copy number profiling as an important tool for risk stratification in human B-cell precursor acute lymphoblastic leukemia. This trial was registered at www.ClinicalTrials.gov as #NCT00003728.
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Affiliation(s)
- Farzaneh Ghazavi
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Belgium Center for Medical Genetics, Ghent University Hospital, Belgium
| | - Emmanuelle Clappier
- Department of Genetics, Robert Debré Hospital, APHP, Paris, France Hematology University Institute, University Paris-Diderot, Paris, France
| | - Tim Lammens
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Belgium
| | | | - Aurélie Caye
- Department of Genetics, Robert Debré Hospital, APHP, Paris, France Hematology University Institute, University Paris-Diderot, Paris, France
| | - Samira Zegrari
- Department of Genetics, Robert Debré Hospital, APHP, Paris, France
| | - Marleen Bakkus
- Department of Hematology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Belgium
| | - Nathalie Grardel
- Centre de Biologie Pathologie PM Degand, INSERM U837, Lille, France
| | - Yves Benoit
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Belgium
| | - Yves Bertrand
- Institute of Hematology and Oncology Paediatrics, Hospices Civils de Lyon, France
| | | | - Vitor Costa
- Department of Pediatrics, Portuguese Oncology Institute, Porto, Portugal
| | - Alina Ferster
- Department of Hemato-Oncology, HUDERF, Brussels, Belgium
| | | | - Geneviève Plat
- Department of Hematology, Children's Hospital, Toulouse, France
| | | | - Marilyne Poirée
- Department of Pediatric Onco-Hematology, Archet University Hospital, Nice, France
| | - Anne Uyttebroeck
- Department of Pediatric Hematology-Oncology, University Hospitals Leuven, Belgium
| | | | - Karima Yakouben
- Department of Pediatric Hematology, Robert Debré Hospital, APHP, Paris, France
| | - Hetty Helsmoortel
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Belgium Center for Medical Genetics, Ghent University Hospital, Belgium
| | - Magali Meul
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Belgium
| | - Nadine Van Roy
- Center for Medical Genetics, Ghent University Hospital, Belgium
| | - Jan Philippé
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, Belgium
| | - Frank Speleman
- Center for Medical Genetics, Ghent University Hospital, Belgium
| | - Hélène Cavé
- Department of Genetics, Robert Debré Hospital, APHP, Paris, France Hematology University Institute, University Paris-Diderot, Paris, France
| | | | - Barbara De Moerloose
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Belgium
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45
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Moyal ECJ, Massabeau C, Filleron T, Modesto A, Bachaud J, Rouquette I, Dierickx L, Aziza R, Bigay-Gamé L, Plat G, Mounier M, Gomez-Roca C, Delord J, Mazieres J. Continuous Infusion of Cilengitide with Radio-Chemotherapy in Stage III Nsclc: a Phase I Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu348.14] [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: 11/14/2022] Open
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46
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Domenech C, Suciu S, De Moerloose B, Mazingue F, Plat G, Ferster A, Uyttebroeck A, Sirvent N, Lutz P, Yakouben K, Munzer M, Röhrlich P, Plantaz D, Millot F, Philippet P, Dastugue N, Girard S, Cavé H, Benoit Y, Bertrandfor Y. Dexamethasone (6 mg/m2/day) and prednisolone (60 mg/m2/day) were equally effective as induction therapy for childhood acute lymphoblastic leukemia in the EORTC CLG 58951 randomized trial. Haematologica 2014; 99:1220-7. [PMID: 24727815 PMCID: PMC4077084 DOI: 10.3324/haematol.2014.103507] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 04/04/2014] [Indexed: 02/05/2023] Open
Abstract
Dexamethasone could be more effective than prednisolone at similar anti-inflammatory doses in the treatment of childhood acute lymphoblastic leukemia. In order to check if this "superiority" of dexamethasone might be dose-dependent, we conducted a randomized phase III trial comparing dexamethasone (6 mg/m(2)/day) to prednisolone (60 mg/m(2)/day) in induction therapy. All newly diagnosed children and adolescents with acute lymphoblastic leukemia in the 58951 EORTC trial were randomized on prephase day 1 or day 8. The main endpoint was event-free survival; secondary endpoints were overall survival and toxicity. A total of 1947 patients with acute lymphoblastic leukemia were randomized. At a median follow-up of 6.9 years, the 8-year event-free survival rate was 81.5% in the dexamethasone arm and 81.2% in the prednisolone arm; the 8-year overall survival rates were 87.2% and 89.0% respectively. The 8-year incidences of isolated or combined central nervous system relapse were 2.9% and 4.5% in the dexamethasone and prednisolone arms, respectively. The incidence of grade 3-4 toxicities during induction and the frequency of osteonecrosis were similar in the two arms. In conclusion, dexamethasone and prednisolone, used respectively at the doses of 6 and 60 mg/m(2)/day during induction, were equally effective and had a similar toxicity profile. Dexamethasone decreased the 8-year central nervous system relapse incidence by 1.6%. This trial was registered at www.clinicaltrials.gov as #NCT00003728.
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Affiliation(s)
- Carine Domenech
- Institute of Hematology and Oncology Pediatrics, Hospices Civils de Lyon, University Claude Bernard Lyon I, France
| | | | | | | | - Geneviève Plat
- Department of Hematology, Children's Hospital, Toulouse, France
| | - Alina Ferster
- Department of Pediatrics, University Hospital Gasthuisberg, Leuven, Belgium
| | | | - Nicolas Sirvent
- Department of Hemato-Oncology, A Villeneuve Hospital, Montpellier, France
| | - Patrick Lutz
- Department of Hematology, Hautepierre, Strasbourg, France
| | - Karima Yakouben
- Department of Hematology, Robert Debré Hospital, Paris, France
| | - Martine Munzer
- Department of Hematology, American Hospital, Reims, France
| | | | | | - Frederic Millot
- Department of Hematology, J Bernard Hospital, Poitiers, France
| | | | - Nicole Dastugue
- Department of Hematology, Children's Hospital, Toulouse, France
| | - Sandrine Girard
- Department of Hematology, Edouard Herriot Hospital, Hospices Civils de Lyon, France
| | - Hélène Cavé
- Department of Genetics, Robert-Debré Hospital, Paris, France
| | - Yves Benoit
- Department of Pediatric Hematology-Oncology, Ghent University Hospital, Belgium
| | - Yves Bertrandfor
- Institute of Hematology and Oncology Pediatrics, Hospices Civils de Lyon, University Claude Bernard Lyon I, France
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47
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Bernardin S, Millot F, Baruchel A, Chastagner P, Stephan J, Plat G, Nicolini F, Rea D, Gardembas M, Etienne G, Cony-Makhoul P, Giraudier S, Guerci-Bresler A, Guilhot-Gaudeffroy J, Huguet-Rigal F, Rohrlich P, Legros L. SFCE P-19 - La Leucémie Myéloïde Chronique chez les Adolescents et Jeunes Adultes (AJA). Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71635-5] [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: 11/24/2022]
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48
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Seror E, Lambilliotte A, Pacquement H, Gaspar N, Schell M, Plat G, Curtillet C, Reguerre Y, Vaudre G, Haouy S, Helfre S, Gorde-Grosjean S, Schmitt C, Aladjidi N, Boudjemaah S, Claude L, Donadieu J, Landman-Parker J, Leblanc T. Treatment of Children and Adolescents with Classical Hodgkin Lymphoma: Final Results of SFCE MDH03 Study. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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49
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Leveque N, Brouchet L, Lepage B, Hermant C, Bigay-Game L, Plat G, Dahan M, Riviere D, Didier A, Mazieres J. Analyse des délais de prise en charge des cancers thoraciques : étude prospective. Rev Mal Respir 2014; 31:208-13. [DOI: 10.1016/j.rmr.2013.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 07/05/2013] [Indexed: 12/21/2022]
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50
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Clappier E, Auclerc MF, Rapion J, Bakkus M, Caye A, Khemiri A, Giroux C, Hernandez L, Kabongo E, Savola S, Leblanc T, Yakouben K, Plat G, Costa V, Ferster A, Girard S, Fenneteau O, Cayuela JM, Sigaux F, Dastugue N, Suciu S, Benoit Y, Bertrand Y, Soulier J, Cavé H. An intragenic ERG deletion is a marker of an oncogenic subtype of B-cell precursor acute lymphoblastic leukemia with a favorable outcome despite frequent IKZF1 deletions. Leukemia 2013; 28:70-7. [PMID: 24064621 DOI: 10.1038/leu.2013.277] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 09/13/2013] [Accepted: 09/17/2013] [Indexed: 11/09/2022]
Abstract
Oncogenic subtypes in childhood B-cell precursor acute lymphoblastic leukemia (BCP-ALL) are used for risk stratification. However, a significant number of BCP-ALL patients are still genetically unassigned. Using array-comparative genomic hybridization in a selected BCP-ALL cohort, we characterized a recurrent V(D)J-mediated intragenic deletion of the ERG gene (ERG(del)). A breakpoint-specific PCR assay was designed and used to screen an independent non-selected cohort of 897 children aged 1-17 years treated for BCP-ALL in the EORTC-CLG 58951 trial. ERG(del) was found in 29/897 patients (3.2%) and was mutually exclusive of known classifying genetic lesions, suggesting that it characterized a distinct leukemia entity. ERG(del) was associated with higher age (median 7.0 vs. 4.0 years, P=0.004), aberrant CD2 expression (43.5% vs. 3.7%, P<0.001) and frequent IKZF1 Δ4-7 deletions (37.9% vs. 5.3%, P<0.001). However, ERG(del) patients had a very good outcome, with an 8-year event-free survival (8-y EFS) and an 8-year overall survival of 86.4% and 95.6%, respectively, suggesting that the IKZF1 deletion had no impact on prognosis in this genetic subtype. Accordingly, within patients with an IKZF1 Δ4-7 deletion, those with ERG(del) had a better outcome (8-y EFS: 85.7% vs. 51.3%; hazard ratio: 0.16; 95% confidence interval: 0.02-1.20; P=0.04). These findings have implications for further stratification including IKZF1 status.
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Affiliation(s)
- E Clappier
- 1] U944 INSERM and Hematology laboratory, St-Louis Hospital, APHP, Paris, France [2] Department of Genetics, Robert Debré Hospital, APHP, Paris, France [3] Hematology University Institute, University Paris-Diderot, Paris, France
| | - M F Auclerc
- 1] U944 INSERM and Hematology laboratory, St-Louis Hospital, APHP, Paris, France [2] Department of Pediatric Hematology, St-Louis Hospital, APHP, Paris, France
| | - J Rapion
- EORTC Headquarters, Brussels, Belgium
| | - M Bakkus
- Molecular Hematology Laboratory, UZ Brussels, Brussels, Belgium
| | - A Caye
- Department of Genetics, Robert Debré Hospital, APHP, Paris, France
| | - A Khemiri
- Department of Genetics, Robert Debré Hospital, APHP, Paris, France
| | - C Giroux
- Department of Genetics, Robert Debré Hospital, APHP, Paris, France
| | - L Hernandez
- U944 INSERM and Hematology laboratory, St-Louis Hospital, APHP, Paris, France
| | - E Kabongo
- Molecular Hematology Laboratory, UZ Brussels, Brussels, Belgium
| | - S Savola
- MRC-Holland, Amsterdam, The Netherlands
| | - T Leblanc
- Department of Pediatric Hematology, St-Louis Hospital, APHP, Paris, France
| | - K Yakouben
- Department of Pediatric Hematology, Robert-Debré Hospital, APHP, Paris, France
| | - G Plat
- Department of Pediatric Onco-Hematology, University Hospital Purpan, Toulouse, France
| | - V Costa
- Department of Pediatrics, Portuguese Oncology Institute, Porto, Portugal
| | - A Ferster
- Department of Pediatric Onco-Hematology, Children's University Hospital Reine Fabiola, Brussels, Belgium
| | - S Girard
- Hematology Laboratory, IHOP, Lyon, France
| | - O Fenneteau
- Hematology Laboratory, Robert Debré Hospital, APHP, Paris, France
| | - J M Cayuela
- 1] U944 INSERM and Hematology laboratory, St-Louis Hospital, APHP, Paris, France [2] Hematology University Institute, University Paris-Diderot, Paris, France
| | - F Sigaux
- 1] U944 INSERM and Hematology laboratory, St-Louis Hospital, APHP, Paris, France [2] Hematology University Institute, University Paris-Diderot, Paris, France
| | - N Dastugue
- Hematology Laboratory, University Hospital Purpan, Toulouse, France
| | - S Suciu
- EORTC Headquarters, Brussels, Belgium
| | - Y Benoit
- Department of Pediatric Hematology-Oncology, Ghent University Hospital, Ghent, Belgium
| | - Y Bertrand
- Department of Pediatric Hematology, IHOP and Claude Bernard University, Lyon, France
| | - J Soulier
- 1] U944 INSERM and Hematology laboratory, St-Louis Hospital, APHP, Paris, France [2] Hematology University Institute, University Paris-Diderot, Paris, France
| | - H Cavé
- 1] Department of Genetics, Robert Debré Hospital, APHP, Paris, France [2] Hematology University Institute, University Paris-Diderot, Paris, France
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