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Couffignal C, Kolta S, Flamant M, Cazanave C, Haymann JP, Mentré F, Duval X, Leport C, Raffi F, Chêne G, Salamon R, Moatti JP, Pierret J, Spire B, Brun-Vézinet F, Fleury H, Masquelier B, Peytavin G, Garraffo R, Costagliola D, Dellamonica P, Katlama C, Meyer L, Salmon D, Sobel A, Cuzin L, Dupon M, Le Moing V, Marchou B, May T, Morlat P, Rabaud C, Waldner-Combernoux A, Hardel L, Reboud P, Couffin-Cadiergues S, Marchand L, Assuied A, Carrieri P, Habak S, Couturier F, Jadand C, Perrier A, Préau M, Protopopescu C, Schmit J, Chennebault J, Faller J, Magy-Bertrand N, Chirouze C, Humbert P, Longy-Boursier, Neau D, Granier P, Ansart S, Verdon R, Merrien D, Chevojon P, Sobel A, Levy Y, Piroth L, Perronne C, Froguel E, Ceccaldi J, Chidiac C, Grégoire V, Reynes J, Fuzibet JG, Arsac P, Bouvet E, Bricaire F, Monsonego J, Girard P, Guillevin L, Herson S, Molina J, Pialoux G, Sain O, Sellier P, Roblot F, Bani-Sadr F, Michelet C, Lucht F, Debord C, Martin T, De Jaureguiberry J, Bernard L. Nevirapine Use Is Associated with Higher Bone Mineral Density in HIV-1 Positive Subjects on Long-Term Antiretroviral Therapy. AIDS Res Hum Retroviruses 2020; 36:399-405. [PMID: 31891665 DOI: 10.1089/aid.2019.0229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We assessed bone mineral density (BMD) in a cohort of human immunodeficiency virus (HIV)-positive patients after a median of 11 years of combination antiretroviral therapy (cART) and evaluated the respective role of HIV infection and antiretroviral drugs (ARVs). A cross-sectional study of 162 participants (131 male) from the ANRS-C08 cohort was performed with bone dual-energy X-ray absorptiometry (DXA) scans and renal assessment. The window of exposure to ARVs was defined as an exposure of more than six cumulative months during the last 3 years before the DXA evaluation to account for a cumulative exposure that could affect bone remodeling. The association with low BMD (Z-score < -2) was assessed by a multiple logistic regression model. The study population was 50 years (median), hepatitis C virus (HCV) (18%), and hepatitis B virus (HBV) (8%) coinfection with HIV-RNA <50 c/mL in 89%, median CD4 of 619/mm3. Prevalence of low BMD was 18% in males and 6% in females. The factors associated with a Z-score < -2 in males were uric acid renal loss [adjusted odds ratio (aOR): 6.1; 95% confidence interval (CI): 1.2-31.5; p = .03], HCV coinfection (aOR: 4.0; 95% CI: 1.3-12.2; p = .02), and less frequent window of exposure to nevirapine (NVP) (aOR: 0.1; 95% CI: 0.02-0.6; p = .01). For the full study sample, there was a strong positive association between duration of exposure to NVP and lumbar spine Z-score (p = .004). HIV-positive patients exposed to long-term cART have a high incidence of low BMD. Tenofovir disoproxil fumarate and ritonavir-boosted protease inhibitors did not seem to be associated with increased risk of low BMD, whereas NVP exposure appeared to have an independent positive association.
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Affiliation(s)
- Camille Couffignal
- Infection, Antimicrobials, Modeling, Evolution (IAME) UMR 1137, INSERM and Université of Paris, Paris, France
| | - Sami Kolta
- Department of Rheumatology, University Hospital Cochin, Assistance Publique–Hôpitaux de Paris, INSERM UMR-1153, Paris, France
| | - Martin Flamant
- Department of Physiology, University Hospital Bichat, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Charles Cazanave
- Infectious Diseases Department, University Hospital Bordeaux, Bordeaux, France
| | - Jean-Philippe Haymann
- Department of Physiology, University Hospital Tenon, and INSERM UMR_S1155, Paris, France
| | - France Mentré
- Infection, Antimicrobials, Modeling, Evolution (IAME) UMR 1137, INSERM and Université of Paris, Paris, France
| | - Xavier Duval
- Infection, Antimicrobials, Modeling, Evolution (IAME) UMR 1137, INSERM and Université of Paris, Paris, and INSERM CIC1425, Paris, France
| | - Catherine Leport
- Unité COREB (Coordination du Risque Epidémique et Biologique), Assistance Publique–Hôpitaux de Paris, Paris, France
| | - François Raffi
- Infectious Diseases Department, University Hospital Hotel-Dieu, and INSERM CIC 1413, University of Nantes, Nantes, France
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Trarieux-Signol S, Bordessoule D, Ceccaldi J, Malak S, Polomeni A, Fargeas JB, Signol N, Pauliat H, Moreau S. Qu’écrivent les personnes atteintes d’hémopathies malignes dans leurs directives anticipées ? Analyse qualitative de 35 écrits. PSYCHO-ONCOLOGIE 2019. [DOI: 10.3166/pson-2019-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
En France, les directives anticipées (DA) se sont vues reconnaître un statut légal en 2005, renforcé en 2016, toutefois une minorité de personnes fait le choix d’en rédiger. Dans le contexte de la maladie grave, quel est leur contenu ? Quelles informations relatives à leur prise en charge ou leur fin de vie y déposent-elles ? L’objectif de cette recherche qualitative est d’analyser le contenu des DA rédigées par des patients atteints d’hémopathies malignes afin de mieux comprendre leur appropriation. L’étude s’est déroulée en deux étapes sur une durée totale de huit ans et deux mois : un travail préliminaire, rétrospectif et monocentrique et une seconde étape prospective et multicentrique dans six sites français. L’analyse qualitative des DA a été accomplie par un binôme composé d’un hématologue sénior et d’un chercheur en sciences humaines et sociales. Une analyse thématique a été réalisée avec identification des principaux messages et mots clés. Les 35 DA collectées sont investies de trois façons différentes : l’appropriation est 1) purement juridique avec une citation de la loi in extenso sans personnalisation de l’écrit ; 2) centrée sur les actes et traitements médicaux souhaités ou refusés ; 3) un moyen de transmettre des messages personnels à l’attention de leurs proches comme leur confiance, l’amour qu’il leur porte ou les modalités d’obsèques souhaitées. En conclusion, nos résultats objectivent que la rédaction de DA ne se limite pas aux patients en fin de vie et qu’au-delà de la transmission d’informations relatives aux actes ou traitements médicaux, les patients les utilisent pour y déposer des messages personnels à leurs proches. Ce nouveau rôle des DA pourrait favoriser la communication intrafamiliale même si ce n’est pas leur finalité première. Faire évoluer les DA vers un concept plus large, comme une planification anticipée des soins, pourrait être un moyen de repenser l’outil et de toucher un plus grand nombre de personnes.
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Ceccaldi J, Thibert JB, Haddad A, Bouësseau MC, Pottier R, Danic B, Noël S, Monsellier M, Tissot JD, Sannié T, Clavier B, Mamzer MF, Cartron JP, Vernant JP, Hervé C, Garraud O. [Not-for-profit: A report from the fourth annual symposium of ethics held by the National Institute for Blood Transfusion (France)]. Transfus Clin Biol 2017; 24:76-82. [PMID: 28476210 DOI: 10.1016/j.tracli.2017.04.003] [Citation(s) in RCA: 5] [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] [Indexed: 10/19/2022]
Abstract
The not-for-profit issue has been debated in November 2016 in Paris; this issue is one of the four canonical pillars of ethical blood donation. It is intimately bound to benevolence though it is distinct, as not-for-profit calls for institutions while benevolence calls for individuals. It is indeed intended that voluntary blood donors do not benefit from their donation and are thus non-remunerated. Not-for-profit is essential since it refers to the public character of blood as a putative public resource aimed at being shared as a tribute of solidarity. A central question however is linked to the capacity- or not -of public sectors to ensure that blood components are universally available, with special mention to plasma derived drugs, without the contribution of the for profit, private sector.
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Affiliation(s)
- J Ceccaldi
- Espace bioéthique aquitain, hôpital Saint-André, Bordeaux, France
| | - J-B Thibert
- Établissement français du sang Bretagne, Rennes, France
| | - A Haddad
- Département de biologie clinique et banque de sang, hôpital du Sacré-Cœur, université libanaise, Beyrouth, Liban; EA3064, faculté de médecine de Saint-Étienne, université de Lyon, Saint-Étienne, France
| | | | - R Pottier
- EA4569 université Paris-Descartes, laboratoire d'éthique médicale et de médecine légale, Paris, France; Département des sciences humaines et sociales, université Paris-Sorbonne, Paris, France
| | - B Danic
- Établissement français du sang Bretagne, Rennes, France
| | - S Noël
- Établissement français du sang, Saint-Denis, France
| | - M Monsellier
- Fédération française pour le don de sang bénévole, Paris, France
| | - J-D Tissot
- Transfusion interrégionale CRS, 1066 Epalinges, Suisse; Faculté de biologie et de médecine, université de Lausanne, Suisse
| | - T Sannié
- Association française des hémophiles, Paris, France
| | - B Clavier
- Centre de transfusion sanguine des armées, Clamart, France
| | - M-F Mamzer
- EA4569 université Paris-Descartes, laboratoire d'éthique médicale et de médecine légale, Paris, France; UF d'éthique médicale, hôpital Necker-enfants-malades, AP-HP, Paris, France
| | - J-P Cartron
- Institut national de la transfusion sanguine, Paris, France
| | - J-P Vernant
- Institut national de la transfusion sanguine, Paris, France
| | - C Hervé
- EA4569 université Paris-Descartes, laboratoire d'éthique médicale et de médecine légale, Paris, France
| | - O Garraud
- EA3064, faculté de médecine de Saint-Étienne, université de Lyon, Saint-Étienne, France; Institut national de la transfusion sanguine, Paris, France.
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Duc S, Rainfray M, Soubeyran P, Fonck M, Blanc JF, Ceccaldi J, Cany L, Brouste V, Mathoulin-Pélissier S. Predictive factors of depressive symptoms of elderly patients with cancer receiving first-line chemotherapy. Psychooncology 2016; 26:15-21. [PMID: 26913707 DOI: 10.1002/pon.4090] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 12/18/2015] [Accepted: 01/15/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Depression is the most common psychiatric disorder in geriatrics and oncology. For elderly cancer patients, it has a significant impact on quality of life, morbidity, and mortality. Nevertheless, depression is under-diagnosed and under-treated. Cancer management is key in improving the quality of care in this population. We aim to identify sociodemographic, clinical, and treatment-related factors of depression in elderly patients during chemotherapy, thus allowing early detection of patients in need of specific treatment. Further, we investigate whether chemotherapy efficacy and safety are associated with depression. PATIENTS AND METHODS A prospective multicenter cohort composed of incident cases of cancer diagnosed in patients 70 years and older, receiving first-line chemotherapy. Depressive symptoms were measured by the Geriatric Depression Scale at baseline and after four chemotherapy cycles. Associations between depressive symptoms during chemotherapy and patients' clinical and treatment characteristics were identified by logistic regression. RESULTS Among 344 patients measured for depression before chemotherapy, 260 had a second assessment at the fourth treatment cycle. At baseline, 45.4% were depressed, and 44.6% were depressed after the fourth cycle. Independent factors of depression were depressive symptoms at baseline (odds ratio (OR) = 6.7, p < 0.001), malnutrition (OR = 5.1, p = 0.014), and risk of malnutrition (OR = 1.6, p = 0.014). After controlling for missing data, effective chemotherapy was associated with a lower risk of depression (OR = 0.4, p = 0.018). CONCLUSION We highlight the role of depressive symptoms and nutritional status at baseline, on the occurrence of depressive symptoms during chemotherapy. These factors should be taken into account in any pre-treatment consultation and appropriate nutritional and psychiatric preventative measures established. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- S Duc
- Gerontology Department, University Hospital Xavier Arnozan, Pessac, France
| | - M Rainfray
- Gerontology Department, University Hospital Xavier Arnozan, Pessac, France.,Université Bordeaux, Bordeaux, France
| | - P Soubeyran
- Université Bordeaux, Bordeaux, France.,Medical Oncology Department, Institut Bergonié, Comprehensive Cancer Centre, Bordeaux, France
| | - M Fonck
- Medical Oncology Department, Institut Bergonié, Comprehensive Cancer Centre, Bordeaux, France
| | - J F Blanc
- Université Bordeaux, Bordeaux, France.,Gastroenterology Department, University Hospital Saint-André, Bordeaux, France
| | - J Ceccaldi
- Hematology Department, General Center Hospital, Libourne, France
| | - L Cany
- Medical Oncology Department, Polyclinique Francheville, Périgueux, France
| | - V Brouste
- Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Centre, Bordeaux, France
| | - S Mathoulin-Pélissier
- Université Bordeaux, Bordeaux, France.,Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Centre, Bordeaux, France.,INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Clinical Epidemiology and Clinical Investigation Centre CIC-1401, Clinical Epidemiology Module, Bordeaux, France
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Schouman T, Bertolus C, Chaine C, Ceccaldi J, Goudot P. [Surgery guided by customized devices: reconstruction with a free fibula flap]. ACTA ACUST UNITED AC 2014; 115:28-36. [PMID: 24412037 DOI: 10.1016/j.revsto.2013.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 09/17/2013] [Indexed: 11/16/2022]
Abstract
The reconstruction of jaws with a free fibula flap can be anticipated virtually. The simulation can be transferred to the operating theater using customized devices obtained from computer-assisted design and manufacturing in a complete digital workflow. Several alternatives are available, from cutting guides to customized titanium osteosynthesis plates, to obtain the best accuracy and reproducibility of reconstruction. Moreover, these new processes allow integrating prosthetic planning concomitantly with reconstruction. We present the virtual three-dimensional planning method for jaw reconstruction with a free fibula flap and the various alternatives of surgery guided by customized devices provided by this planning.
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Affiliation(s)
- T Schouman
- Service de chirurgie maxillo-faciale et stomatologie, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'hôpital, 75651 Paris cedex 13, France.
| | - C Bertolus
- Service de chirurgie maxillo-faciale et stomatologie, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'hôpital, 75651 Paris cedex 13, France
| | - C Chaine
- Service de chirurgie maxillo-faciale et stomatologie, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'hôpital, 75651 Paris cedex 13, France
| | - J Ceccaldi
- Service de chirurgie maxillo-faciale et stomatologie, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'hôpital, 75651 Paris cedex 13, France
| | - P Goudot
- Service de chirurgie maxillo-faciale et stomatologie, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'hôpital, 75651 Paris cedex 13, France
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Bourdel-Marchasson I, Durrieu J, Doussau A, Germain C, Blanc JF, Lahmar C, Dauba J, Terrebonne E, Lecaille C, Ceccaldi J, Cany L, Lavau-Denes S, Chomy F, Houede N, Soubeyran P, Blanc-Bisson C, Fonck M. Nutritional Advices in Older Patients at Risk for Malnutrition During Chemotherapy for Cancer: No Effect on Mortality Decreased Rate or Severe Infections. Multicentre Inogad Study. J Geriatr Oncol 2013. [DOI: 10.1016/j.jgo.2013.09.197] [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: 11/16/2022]
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Masquelier B, Taieb A, Reigadas S, Marchou B, Cheneau C, Spire B, Charpentier C, Leport C, Raffi F, Chene G, Descamps D, Leport C, Raffi F, Chene G, Salamon R, Moatti JP, Pierret J, Spire B, Brun-Vezinet F, Fleury H, Masquelier B, Peytavin G, Garraffo R, Costagliola D, Dellamonica P, Katlama C, Meyer L, Salmon D, Sobel A, Cuzin L, Dupon M, Duval X, Le Moing V, Marchou B, May T, Morlat P, Rabaud C, Waldner-Combernoux A, Reboud P, Couffin-Cadiergues S, Marchand L, Bouteloup V, Bouhnik AD, Brunet-Francois C, Caron V, Carrieri MP, Courcoul M, Couturier F, Hardel L, Iordache L, Kurkdji P, Martiren S, Preau M, Protopopescu C, Surzyn J, Taieb A, Villes V, Schmit JL, Chennebault JM, Faller JP, Mgy-Bertrand N, Hoen B, Drobachef, Bouchaud O, Dupon M, Longy-Boursier, Morlat P, Ragnaud JM, Granier P, Garre M, Verdon R, Merrien D, Devidas A, Sobel A, Piroth L, Perronne C, Froguel E, Ceccaldi J, Peyramond D, Allard C, Reynes J, May T, Raffi F, Fuzibet JG, Dellamonica P, Arsac P, Bouvet E, Bricaire F, Bergmann P, Cabane J, Monsonego J, Girard PM, Guillevin L, Herson S, Leport C, Meyohas MC, Molina JM, Pialoux G, Salmon D, Roblot P, Jaussaud R, Michelet C, Lucht F, Debord T, Rey D, De Jaureguiberry JP, Marchou B, Bernard L. Cellular HIV-1 DNA quantification and short-term and long-term response to antiretroviral therapy. J Antimicrob Chemother 2011; 66:1582-9. [DOI: 10.1093/jac/dkr153] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Durrieu J, Blanc-Bisson C, Fonck M, Béchade D, Becouarn Y, Blanc JF, Ceccaldi J, Chomy F, Houédé N, Lécaille C, Smith D, Soubeyran P, Terrebonne E, Vergnol J, Bourdel-Marchasson I. Huit fiches pratiques de conseil nutritionnel pour répondre aux besoins des patients âgés au cours de leur traitement de chimiothérapie: étude INOGAD. ONCOLOGIE 2011. [DOI: 10.1007/s10269-011-1985-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Soubeyran P, Bellera CA, Gregoire F, Blanc J, Ceccaldi J, Blanc-Bisson C, Mertens C, Mathoulin-Pélissier S, Fonck M, Rainfray M. Validation of a screening test for elderly patients in oncology. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.20568] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Soubeyran P, Rainfray M, Mathoulin-Pélissier S, Blanc-Bisson C, Mertens C, Blanc J, Ceccaldi J, Imbert Y, Dauba J, Fonck M. Prediction of early death risk in the elderly with cancer: Results of a prospective multicentric study of 364 patients under chemotherapy. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.9040] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9040 Background: When it is time to decide for or against chemotherapy in elderly patients (pts) with cancer, physicians face the difficult balance of risks and benefits. Too much often, decision is based on empirical feelings rather than reliable and objective factors which are frequently lacking. Yet, elderly pts can benefit from chemotherapy in many situations. Method: To help physicians in the decision process of chemotherapy through identification of factors predicting early death (< 6 months) from the onset of chemotherapy, we performed a prospective accrual of pts older than 70 with various types of cancer treated by 1st line chemotherapy. Baseline geriatric assessment (GA) (MMS, Get up and go, ADL, IADL, MNA, GDS15 , CIRS-G). Treatment was applied by the oncologist according to current standards disregarding GA results. Factors tested were: age, sex, advanced disease, renal and cardiac function, blood counts, performance status (PS), comorbidities and GA data. Results: 364 pts were accrued in 12 centres. Localisations were: lymphomas (110), colon (101), stomach (37), lung (37), pancreas (23), prostate (20), bladder (18), ovary (14) and unknown origin carcinomas (4). Main characteristics: median age (77.5 y. - range: 70- 99), sex ratio H/F (1.43), advanced tumours (66% - metastatic cancer or aaIPI 2–3 for lymphomas), PS>1 (28%), creatinine clearance <50 ml/mn (42%). GA showed 32% of pts ADL-dependent, 70% IADL-dependent, risk of falls in 12.4%, 19.2% MMS<24, 30% GDS15 >6, 63.4% MNA<23.5, 38.2% = 1 CIRS-G gr. 3–4 category. 357 pts have been followed up for more than 6 months and 59 pts died during this period. Only advanced disease (OR: 4.2 - CI95:1.7–10.3) and MNA score (OR: 4.5 - CI95: 1.75–11.6) predicted early death in logistic regression model. In advanced tumours, risk of early death varied from 11% in pts with MNA>23.5 to 40% in pts with MNA<17. Conclusions: In pts older than 70 with cancer, disease extension and MNA could predict for early death. MNA, performed by a trained nurse, should probably be added to routine pre- treatment work-up in these pts to screen for multidisciplinary assessment and management by oncologists and geriatricians. Sponsored by PHRC, sanofi-aventis, Amgen, Pfizer [Table: see text]
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Affiliation(s)
- P. Soubeyran
- Institut Bergonié, Bordeaux, France; CHU Bordeaux, Bordeaux, France; Centre Hospitalier, Libourne, France; Centre Hospitalier, Agen, France; Centre Hospitalier, Mont de Marsan, France
| | - M. Rainfray
- Institut Bergonié, Bordeaux, France; CHU Bordeaux, Bordeaux, France; Centre Hospitalier, Libourne, France; Centre Hospitalier, Agen, France; Centre Hospitalier, Mont de Marsan, France
| | - S. Mathoulin-Pélissier
- Institut Bergonié, Bordeaux, France; CHU Bordeaux, Bordeaux, France; Centre Hospitalier, Libourne, France; Centre Hospitalier, Agen, France; Centre Hospitalier, Mont de Marsan, France
| | - C. Blanc-Bisson
- Institut Bergonié, Bordeaux, France; CHU Bordeaux, Bordeaux, France; Centre Hospitalier, Libourne, France; Centre Hospitalier, Agen, France; Centre Hospitalier, Mont de Marsan, France
| | - C. Mertens
- Institut Bergonié, Bordeaux, France; CHU Bordeaux, Bordeaux, France; Centre Hospitalier, Libourne, France; Centre Hospitalier, Agen, France; Centre Hospitalier, Mont de Marsan, France
| | - J. Blanc
- Institut Bergonié, Bordeaux, France; CHU Bordeaux, Bordeaux, France; Centre Hospitalier, Libourne, France; Centre Hospitalier, Agen, France; Centre Hospitalier, Mont de Marsan, France
| | - J. Ceccaldi
- Institut Bergonié, Bordeaux, France; CHU Bordeaux, Bordeaux, France; Centre Hospitalier, Libourne, France; Centre Hospitalier, Agen, France; Centre Hospitalier, Mont de Marsan, France
| | - Y. Imbert
- Institut Bergonié, Bordeaux, France; CHU Bordeaux, Bordeaux, France; Centre Hospitalier, Libourne, France; Centre Hospitalier, Agen, France; Centre Hospitalier, Mont de Marsan, France
| | - J. Dauba
- Institut Bergonié, Bordeaux, France; CHU Bordeaux, Bordeaux, France; Centre Hospitalier, Libourne, France; Centre Hospitalier, Agen, France; Centre Hospitalier, Mont de Marsan, France
| | - M. Fonck
- Institut Bergonié, Bordeaux, France; CHU Bordeaux, Bordeaux, France; Centre Hospitalier, Libourne, France; Centre Hospitalier, Agen, France; Centre Hospitalier, Mont de Marsan, France
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Ruhin B, Menard P, Ceccaldi J, Dichamp J, Bertrand JC. Lambeau libre de péroné en double barre : intérêt du montage dans les reconstructions mandibulaires pour une réhabilitation prothétique sur implants (5 cas). ACTA ACUST UNITED AC 2006; 107:338-44; discussion 345-6. [PMID: 17128183 DOI: 10.1016/s0035-1768(06)77060-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION As major loss of mandibular bone stock requires a vascularized transfer, fibula free flap reconstruction is considered to be the best free flap for its length and reliability. Its main advantage is to accept dental implants. Single or double-barrel reconstruction can be performed. Double-barrel reconstruction is generally preferred because the bone superposition offers enough height to allow dental implants. MATERIAL AND METHODS We reviewed five selected cases of double-barrel fibula free flap adaptive mandibular reconstruction performed among a series of 11 oral rehabilitations with planned dental implants, focusing on the technical aspects. RESULTS Today, dental rehabilitation has been achieved in three double-barrel fibula flaps. Details are reported concerning the implant step. DISCUSSION In this perspective, we discuss the choice of the reconstructive technique in order to obtain adequate bone height. Early in our experience and for different reasons discussed in the text, we used a single barrel fibula flap. This technique provided sufficient height in some cases, but had to be completed by bone grafts in few patients. Our experience illustrates the usefulness of the double barrel technique which provide definitive bone height sufficient for dental implants. The double-barreled technique should be considered as the best solution.
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Affiliation(s)
- B Ruhin
- Service de Chirurgie Maxillo-faciale et Stomatologie, Hôpital de la Pitié Salpêtrière, Paris.
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12
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Soubeyran P, Rainfray M, Mathoulin-Pelissier S, Blanc-Bisson C, Mertens C, Blanc J, Ravaud A, Ceccaldi J, Imbert Y, Vogt L, Dauba J, Pallis R, Cany L, Buy E, Andria F, Adhoute X, Chomy F, Fonck M. O14 Screening of elderly patient with cancer for early death risk. Results of a prospective multicentric study of 364 patients under chemotherapy. Crit Rev Oncol Hematol 2006. [DOI: 10.1016/s1040-8428(13)70071-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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13
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Soubeyran PL, Demeaux H, Blanc-Bisson C, Mathoulin-Pelissier S, Ceccaldi J, Fitoussi O, Kind M, Lupo R, Picot V, Hoerni B. Association of liposomal pegylated doxorubicine, fludarabine and cyclophosphamide as first line treatment in disseminated small B-cell lymphoma in adult patients. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- P.-L. Soubeyran
- Comprehensive Cancer Ctr, Bordeaux, Cedex, France; CHU, Bordeaux, France; CH Robert Boulin, Libourne, France; Polyclinique Bordeaux-Nord, Bordeaux, France; Clin Saint Anne, Langon, France
| | - H. Demeaux
- Comprehensive Cancer Ctr, Bordeaux, Cedex, France; CHU, Bordeaux, France; CH Robert Boulin, Libourne, France; Polyclinique Bordeaux-Nord, Bordeaux, France; Clin Saint Anne, Langon, France
| | - C. Blanc-Bisson
- Comprehensive Cancer Ctr, Bordeaux, Cedex, France; CHU, Bordeaux, France; CH Robert Boulin, Libourne, France; Polyclinique Bordeaux-Nord, Bordeaux, France; Clin Saint Anne, Langon, France
| | - S. Mathoulin-Pelissier
- Comprehensive Cancer Ctr, Bordeaux, Cedex, France; CHU, Bordeaux, France; CH Robert Boulin, Libourne, France; Polyclinique Bordeaux-Nord, Bordeaux, France; Clin Saint Anne, Langon, France
| | - J. Ceccaldi
- Comprehensive Cancer Ctr, Bordeaux, Cedex, France; CHU, Bordeaux, France; CH Robert Boulin, Libourne, France; Polyclinique Bordeaux-Nord, Bordeaux, France; Clin Saint Anne, Langon, France
| | - O. Fitoussi
- Comprehensive Cancer Ctr, Bordeaux, Cedex, France; CHU, Bordeaux, France; CH Robert Boulin, Libourne, France; Polyclinique Bordeaux-Nord, Bordeaux, France; Clin Saint Anne, Langon, France
| | - M. Kind
- Comprehensive Cancer Ctr, Bordeaux, Cedex, France; CHU, Bordeaux, France; CH Robert Boulin, Libourne, France; Polyclinique Bordeaux-Nord, Bordeaux, France; Clin Saint Anne, Langon, France
| | - R. Lupo
- Comprehensive Cancer Ctr, Bordeaux, Cedex, France; CHU, Bordeaux, France; CH Robert Boulin, Libourne, France; Polyclinique Bordeaux-Nord, Bordeaux, France; Clin Saint Anne, Langon, France
| | - V. Picot
- Comprehensive Cancer Ctr, Bordeaux, Cedex, France; CHU, Bordeaux, France; CH Robert Boulin, Libourne, France; Polyclinique Bordeaux-Nord, Bordeaux, France; Clin Saint Anne, Langon, France
| | - B. Hoerni
- Comprehensive Cancer Ctr, Bordeaux, Cedex, France; CHU, Bordeaux, France; CH Robert Boulin, Libourne, France; Polyclinique Bordeaux-Nord, Bordeaux, France; Clin Saint Anne, Langon, France
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14
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Le Moing V, Lewden C, Bonnet B, Meyohas M, Boucherit S, Katlama C, Ceccaldi J, Chêne G, Leport C, Raffi F. CL2-03 Réponse immuno-virologique à long terme après relai par inhibiteur non nucléosidique de la transcriptase inverse (INNTI) ou abacavir (ABC) chez les patients infectés par le VIH répondeurs virologiques à un traitement comprenant un inhibiteur de protéase (IP). Med Mal Infect 2004. [DOI: 10.1016/s0399-077x(04)90034-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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15
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Bonnet F, Thiébaut R, Chêne G, Neau D, Pellegrin J, Ceccaldi J, Mercié P, Beylot J, Dabis F, Salamon R, Morlat P, GECSA. La valeur absolue des lymphocytes CD4+ n'est pas le seul paramètre à considérer pour initier une multithérapie antirétrovirale (MARV) chez les sujets infectés par le VIH : étude de cohorte de 709 patients. Rev Med Interne 2003. [DOI: 10.1016/s0248-8663(03)80409-5] [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: 11/16/2022]
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16
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Dagada C, Soubeyran P, Hembert K, Monnereau A, Ehgbali H, Ceccaldi J, Guichard P, Hallé O, Rémuzon P, Demeaux H. 1012 Prediction of severe neutropenia in elderly patients with aggressive lymphoma treated by an anthracycline containing regimen. EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)91039-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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17
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Marimoutou C, Chêne G, Mercié P, Neau D, Farbos S, Morlat P, Ceccaldi J, Dabis F. Prognostic factors of combined viral load and CD4+ cell count responses under triple antiretroviral therapy, Aquitaine cohort, 1996-1998. J Acquir Immune Defic Syndr 2001; 27:161-7. [PMID: 11404538 DOI: 10.1097/00126334-200106010-00011] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the viroimmunologic response and its prognostic factors 6 months after initiating triple antiretroviral therapy in a cohort of HIV-1-infected patients. METHODS Positive virologic response during follow-up (VL+) was defined as plasma HIV RNA level <500 copies/ml and positive immunologic response (CD4+) as an increase of CD4+ count of at least 50 cells/mm3. Four categories of response were defined: VL+/CD4+; VL+/CD4-; VL-/CD4+ and VL-/CD4-. Prognostic factors were studied through a polytomous logistic regression (VL-/CD4-, as reference). RESULTS Baseline characteristics of the 478 studied patients were: 22% at AIDS stage, 77% pretreated, median CD4+ cell count 195/mm3 and HIV RNA level 4.42 log. At 6 months 37.5% were VL+/CD4+; 15.7% VL+/CD4-; 23.8% VL-/CD4+ and 23.0% VL-/CD4-. Baseline HIV RNA level was associated to a higher risk of VL-/CD4+ response. More advanced age was associated with a higher risk of isolated immunologic failure (VL+/CD4-), whereas pretreatment and saquinavir therapy were associated with a lower frequency of positive virologic response independently of immunologic response. CONCLUSION HIV-RNA level, pretreatment, and saquinavir therapy were already known to be linked to therapeutic response. Based on our results, a high baseline HIV-RNA level is associated with isolated immunologic response; moreover, age should be of importance in treatment decision.
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Affiliation(s)
- C Marimoutou
- GECSA-INSERM Unité 330, Université Victor Segalen Bordeaux 2, 146 rue Leo Saignat, 33076 Bordeaux, France
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18
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Lockhart R, Ceccaldi J, Bertrand JC. Postoperative maxillary cyst following sinus bone graft: report of a case. Int J Oral Maxillofac Implants 2000; 15:583-6. [PMID: 10960993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Sinus bone grafting with autogenous bone is routinely performed to allow placement of endosseous dental implants. Although numerous maxillary sinuses have been successfully grafted, some complications of this procedure have been reported. These include maxillary sinusitis, resorption, infection and possible failure of grafts, loss of implants after 1-stage surgery, and oroantral fistulae. Only one case of postoperative maxillary cyst developing in the graft has been reported in the literature. Here, the authors report a similar case that necessitated grafting of the cyst with autologous iliac bone.
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Affiliation(s)
- R Lockhart
- Department of Oral and Maxillofacial Surgery, Groupe Hospitalier Pitié-Salpétrière, Paris, France
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19
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Chêne G, Binquet C, Moreau JF, Neau D, Pellegrin I, Malvy D, Ceccaldi J, Lacoste D, Dabis F. Changes in CD4+ cell count and the risk of opportunistic infection or death after highly active antiretroviral treatment. Groupe d'Epidémiologie Clinique du SIDA en Aquitaine. AIDS 1998; 12:2313-20. [PMID: 9863874 DOI: 10.1097/00002030-199817000-00013] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To study the relationship between the CD4+ cell response after initiation of protease inhibitors and the occurrence of opportunistic infections and survival. DESIGN Prospective observational cohort study. METHODS HIV-1-seropositive subjects followed-up in HIV centres of Bordeaux University Hospital, Southwest France who were prescribed at least one available protease inhibitor between January and December 1996 were included in this analysis. A Cox model estimated the independent effect of baseline covariates and CD4+ cell response, considered as a time-dependent covariate, on the occurrence of new AIDS-defining opportunistic infection, new AIDS-defining events, new AIDS-defining opportunistic infection or death. RESULTS A total of 556 HIV-positive patients were prescribed at least one protease inhibitor: 34% saquinavir, 52% indinavir, and 14% ritonavir. Median CD4+ cell count at baseline was 95 x 10(6)/l and mean plasma HIV RNA was 5.0 log10 copies/ml. After a median follow-up of 230 days, 65 patients experienced a new episode of opportunistic infection, 79 patients experienced at least one AIDS-defining event, and 24 had died. On average, the increase in CD4+ cell count was 42 x 10(6)/l (SD, 74) after a median of 49 days. In the multivariate analysis of opportunistic infection or death, each 50% higher CD4+ cell count at baseline was associated with a 23% reduction [95% confidence interval (CI), 14-30] of risk. Each 50% increase in CD4+ cell count during follow-up was associated with a 9% reduction (95% CI, 2-15) of risk, adjusted for the presence of AIDS prior to protease inhibitor therapy (hazard ratio, 3.76 versus absence of AIDS; P < 0.01) and haemoglobin level (hazard ratio, 0.48 if > 11 g/dl versus <11 g/dl; P < 0.01). CONCLUSION Our results show, at least indirectly, how protease inhibitors might produce clinical stabilization. This result may be due to improved functionality of CD4+ cells in patients started on protease inhibitors.
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Affiliation(s)
- G Chêne
- Unité INSERM 330, Université Victor Segalen Bordeaux 2, France
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20
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Morlat P, Dequae-Merchadou L, Dabis F, Pellegrin I, Nouts C, Dutronc H, Cazorla C, Mercié P, Neau D, Malvy D, Bernard N, Ceccaldi J, Bonnal F, Beylot J. Bithérapie d'analogues nucléosidiques en traitement initial antirétroviral: étude de cohorte de 626 patients. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)80056-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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21
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Marimoutou C, Chêne G, Pellegrin I, Moreau JF, Spira R, Neau D, Lacoste D, Ceccaldi J, Malvy D, Dabis F. CD4+ lymphocyte count and plasma HIV RNA levels in a survey of 1602 HIV-infected patients in Bordeaux, France, 1996-1997. Groupe d'Epidemiologie Clinique da SIDA en Aquitaine. AIDS 1998; 12:962-4. [PMID: 9631157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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22
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Soum F, Trille JA, Auvergnat JC, Giraud P, Bicart-See A, Marchou B, Ceccaldi J, Mihura J, Daly Schveitzer N. Low-dose splenic irradiation in the treatment of immune thrombocytopenia in HIV-infected patients. Int J Radiat Oncol Biol Phys 1998; 41:123-6. [PMID: 9588926 DOI: 10.1016/s0360-3016(98)00036-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To determine the effect of low-dose splenic irradiation on severe Zidovudine-resistant, HIV-1-associated thrombocytopenia (HAT). METHODS AND MATERIALS Between September 1994 and October 1996, 17 patients were included in a prospective study. The patients met the following criteria for inclusion: hemorrhagic symptoms or a platelet count below or equal to 50 x 10(9)/l and normal numbers of megakaryocytes on bone aspiration. The mean baseline platelet count was 20.3 (+/- 14.4) x 10(9)/l; four patients had a platelet count inferior to 10 x 10(9)/l. Splenic volume was defined by ultrasonography. A total dose of 9 Gy was given using an isocentric parallel pair field technique. RESULTS One month after the end of treatment six patients had a significant rise in their platelet count. Clinically, hemorrhagic symptoms stopped for all patients that were symptomatic. Unfortunately, duration of response was short because for one patient only the platelet count remains stable with a follow-up of 6 months. All patients are alive and in recent evaluation, with four out of eight patients receiving a combination of antiretroviral therapy had a platelet count above 50 x 10(9)/l. CONCLUSION Our results are disappointing concerning the duration of response, especially comparatively to those reported in autoimmune thrombocytopenia. Mechanisms of HAT are more complex, and megakaryocytes' infection may play an important role. Splenic irradiation should be considered as palliative treatment for the minority of patients with severe bleeding that does not respond to standard medical treatment.
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Affiliation(s)
- F Soum
- Centre Claudius Regaud, Service de Radiotherapie, Toulouse, France
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23
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Labouyrie E, Chartois-Leauté AG, Dubus P, Duchayne E, Brousset P, Ceccaldi J, Capbern M, Fialon P, Soubeyran P, Delsol G, de Mascarel A, Merlio JP. [Splenic lymphoma with villous lymphocytes: morphologic, immunologic and molecular study. Report of three cases]. Ann Pathol 1996; 16:285-91. [PMID: 9172620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Splenic lymphoma with villous lymphocytes (SLVL) is a low grade lymphoproliferation characterized by a massive splenomegaly, an absence of lymphadenopathy and the presence in the peripheral blood of atypical B-lymphocytes with hairy-cell appearance. We have studied the morphological, immunological and molecular characteristics of 3 cases of SLVL. SLVL presented on blood smears characteristic irregularities of the plasma membrane consisting in thin and short villi unevenly distributed. The main phenotype was CD5-, CD11c+, and CD25-, but individual SLVL cases can not be identified by using immunohistochemical criteria alone. Clonal rearrangements of the immunoglobulin heavy chain gene were found in all 3 cases and in one case presented a bcl2-JH rearrangement. SLVL are clonal B-cell lymphoproliferations and can be associated with t(14; 18) translocation.
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MESH Headings
- Aged
- Aged, 80 and over
- Antigens, CD/analysis
- Antigens, Neoplasm/analysis
- Female
- Gene Rearrangement, B-Lymphocyte, Heavy Chain
- Genes, Immunoglobulin
- Genes, bcl-2
- Genotype
- Herpesvirus 4, Human/isolation & purification
- Humans
- Immunophenotyping
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/immunology
- Lymphoma, B-Cell/pathology
- Male
- Splenic Neoplasms/genetics
- Splenic Neoplasms/immunology
- Splenic Neoplasms/pathology
- Splenomegaly/immunology
- Splenomegaly/pathology
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Affiliation(s)
- E Labouyrie
- Laboratoire d'Anatomie Pathologique, Hôpital Haut-Levêque, CHU Bordeaux
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Marit G, Fabères C, Boiron JM, Fourès C, Puntous M, Cony-Makhoul P, Bernard P, Merlet M, Lorin JC, Ceccaldi J. Autologous blood progenitor cell transplantation in high-risk multiple myeloma. Stem Cells 1995; 13 Suppl 2:160-3. [PMID: 8520506 DOI: 10.1002/stem.5530130726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The aim of the study was to evaluate the feasibility and the efficacy of high-dose chemoradiotherapy followed by autologous hematopoietic stem cell support with peripheral blood progenitor cells (PBPC) harvested after high-dose cyclophosphamide (HDCYC) treatment in patients with high-risk multiple myeloma (MM). Inclusion criteria were: age less than 65 years and high-risk MM defined as stage II MM, stage III MM, refractory or relapsed MM. The design of the study was: 1) HDCYC +/- hematopoietic growth factors followed by PBPC collection, and 2) high-dose melphalan combined with total body irradiation (or busulfan for previously irradiated patients) followed by PBPC reinfusion (ABPCT). All 60 patients completed the procedure except two who died from infection after HDCYC and another of acute cardiac failure after reinfusion of PBPC. Out of the 60 evaluable patients, three failed to respond while the other 57 achieved either a partial (n = 33) or complete (n = 24) response. Thirty-one patients progressed or relapsed after a median duration of response of 15 months (range: 3-43). The median follow-up for the other 26 responder patients was 24 months (range: 2-66). Twenty-one patients died, 18 of MM (2 after failure, 16 after relapse) and three responders of lung cancer (n = 1) and infection (n = 2). In conclusion, this study shows that this therapeutic approach is feasible and efficient.
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Affiliation(s)
- G Marit
- Bone Marrow Transplant Unit, Hôpital Haut-Lévèque, CHU Bordeaux, Pessac, France
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Ceccaldi J, Neujean G. Letter To Editor. Am J Trop Med Hyg 1949. [DOI: 10.4269/ajtmh.1949.s1-29.983] [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: 11/07/2022] Open
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