1
|
Aubin L, Vilas Boas R, Daltro De Oliveira R, Le Brun V, Divoux M, Rey J, Mansier O, Ianotto JC, Pastoret C, Desmares A, Murati A, de Mas V, Tavitian S, Girodon F, Soret Dulphy J, Maslah N, Goncalves Monteiro V, Boyer F, Orvain C, Ranta D, Cayssials É, Le Clech L, Nicol C, Rottier C, Botin Lopez T, Castel B, Rispal P, Beziat G, Bescond C, Laribi K, Benajiba L, Ugo V, Lippert E, Cottin L, Luque Paz D. CALR-mutated patients with low allele burden represent a specific subtype of essential thrombocythemia: A study on behalf of FIM and GBMHM. Am J Hematol 2024; 99:1001-1004. [PMID: 38404143 DOI: 10.1002/ajh.27265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/27/2024]
Abstract
A low allele burden (i.e., <20%) of the CALR driver mutation is found in 10.8% of CALR-mutated MPNs, mostly in essential thrombocythemia, and correlates with a milder phenotype and a more indolent evolution compared to patients with an allele burden ≥20%.
Collapse
Affiliation(s)
- Laura Aubin
- Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, CRCI2NA, Angers, France
- Laboratoire d'Hématologie, CH St Malo, St Malo, France
- Laboratoire d'Hématologie, CHU Rennes, Rennes, France
| | | | | | | | - Marion Divoux
- Hématologie Clinique, CHU Nancy, Nancy, France
- Laboratoire d'Hématologie, CHU Nancy, Nancy, France
| | - Jérôme Rey
- Centre de Recherche en Cancérologie de Marseille (CRCM), Département d'Hématologie, Institut Paoli-Calmettes, CRCM, Inserm, Marseille, France
| | - Olivier Mansier
- Laboratoire d'Hématologie, CHU Bordeaux, Bordeaux, France
- Inserm U1034, Université de Bordeaux, Bordeaux, France
| | | | | | - Anne Desmares
- Laboratoire d'Hématologie, CHU Rennes, Rennes, France
| | - Anne Murati
- Centre de Recherche en Cancérologie de Marseille (CRCM), Département de Biopathologie et Département d'Oncologie Prédictive, Institut Paoli-Calmettes, Inserm, Marseille, France
| | - Véronique de Mas
- Laboratoire d'Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, CHU Toulouse, Toulouse, France
| | - Suzanne Tavitian
- Service d'Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, CHU Toulouse, Toulouse, France
| | | | - Juliette Soret Dulphy
- INSERM U944/CNRS UMR7212, Hôpital Saint Louis APHP, Université de Paris, Paris, France
| | - Nabih Maslah
- Laboratoire de Biologie Cellulaire, Université Paris Cité, APHP, Hôpital Saint-Louis, Paris, France
| | | | | | | | - Dana Ranta
- Hématologie Clinique, CHU Nancy, Nancy, France
| | - Émilie Cayssials
- Service d'Oncologie Hématologique et Thérapie Cellulaire, CHU de Poitiers, Poitiers, France
| | | | | | - Camille Rottier
- Laboratoire d'oncobiologie moléculaire, CHU Amiens-Picardie, Amiens, France
| | | | - Brice Castel
- Service de Médecine Interne, CH de Bigorre, Tarbes, France
| | | | | | | | - Kamel Laribi
- Hématologie Clinique, CH Le Mans, Le Mans, France
| | - Lina Benajiba
- INSERM U944/CNRS UMR7212, Hôpital Saint Louis APHP, Université de Paris, Paris, France
| | - Valérie Ugo
- Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, CRCI2NA, Angers, France
| | - Eric Lippert
- Laboratoire d'Hématologie, CHRU Brest, Brest, France
- INSERM, U1078, Université de Brest, Brest, France
| | - Laurane Cottin
- Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, CRCI2NA, Angers, France
| | - Damien Luque Paz
- Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, CRCI2NA, Angers, France
| |
Collapse
|
2
|
Thouault L, Leven C, Eveillard JR, Kerspern H, Plée-Gautier E, Ianotto JC, Carre JL, Capaldo C. Assessment of the lipemia index determined by the Atellica CH 930 analyzer for the detection of monoclonal immunoglobulins. Clin Chem Lab Med 2024; 62:e68-e71. [PMID: 37682288 DOI: 10.1515/cclm-2023-0872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/01/2023] [Indexed: 09/09/2023]
Affiliation(s)
- Luc Thouault
- Department of Biochemistry and Pharmaco-Toxicology, Brest University Hospital, Brest, France
| | - Cyril Leven
- Department of Biochemistry and Pharmaco-Toxicology, Brest University Hospital, Brest, France
- Inserm, UMR 1304 (GETBO), Western Brittany Thrombosis Study Group, Western Brittany University, Brest, France
| | | | - Hélène Kerspern
- Department of Biochemistry and Pharmaco-Toxicology, Brest University Hospital, Brest, France
- Univ Brest, LIEN, Brest, France
| | - Emmanuelle Plée-Gautier
- Department of Biochemistry and Pharmaco-Toxicology, Brest University Hospital, Brest, France
- Univ Brest, LIEN, Brest, France
| | - Jean-Christophe Ianotto
- Inserm, UMR 1304 (GETBO), Western Brittany Thrombosis Study Group, Western Brittany University, Brest, France
- Department of Hematology, Brest University Hospital, Brest, France
| | - Jean-Luc Carre
- Department of Biochemistry and Pharmaco-Toxicology, Brest University Hospital, Brest, France
- Univ Brest, LIEN, Brest, France
| | - Clément Capaldo
- Department of Biochemistry and Pharmaco-Toxicology, Brest University Hospital, Brest, France
| |
Collapse
|
3
|
Galtier J, Drevon L, Le Bris Y, Giraudier S, Wemeau M, Legros L, Luque Paz D, Girodon F, Kiladjian JJ, Mesguich C, Parrens M, Mediavilla C, Roy L, Guy A, Mansier O, Ianotto JC, James C. Role of red cell mass evaluation in myeloproliferative neoplasms with splanchnic vein thrombosis and normal hemoglobin value: a study of the France Intergroupe des Syndromes myeloprolifératifs. Haematologica 2024. [PMID: 38328854 DOI: 10.3324/haematol.2023.284488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Indexed: 02/09/2024] Open
Abstract
Not available.
Collapse
Affiliation(s)
- Jean Galtier
- Service d'hématologie et thérapie cellulaire, CHU de Bordeaux.
| | - Louis Drevon
- Service d'hématologie clinique, Hôpital Saint-Louis, APHP
| | | | | | | | | | | | | | | | | | - Marie Parrens
- Service d'anatomie et cytologie pathologique, CHU de Bordeaux
| | | | - Lydia Roy
- Service d'Hématologie Clinique, Hôpital Universitaire Henri Mondor, AP-HP and Faculté de Santé, UPEC, Créteil
| | | | - Olivier Mansier
- Service d'hématologie biologique, CHU de Bordeaux, France; Univ. Bordeaux, INSERM, Biologie des maladies cardiovasculaires, U1034, F-33600 Pessac
| | | | - Chloe James
- Service d'hématologie biologique, CHU de Bordeaux, France; Univ. Bordeaux, INSERM, Biologie des maladies cardiovasculaires, U1034, F-33600 Pessac
| |
Collapse
|
4
|
Pasquer H, Daltro de Oliveira R, Vasseur L, Soret-Dulphy J, Maslah N, Zhao LP, Marcault C, Cazaux M, Gauthier N, Verger E, Parquet N, Vainchenker W, Raffoux E, Ugo V, Luque Paz D, Roy L, Lambert WC, Ianotto JC, Lippert E, Giraudier S, Cassinat B, Kiladjian JJ, Benajiba L. Distinct clinico-molecular arterial and venous thrombosis scores for myeloproliferative neoplasms risk stratification. Leukemia 2024; 38:326-339. [PMID: 38148396 DOI: 10.1038/s41375-023-02114-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/30/2023] [Accepted: 12/06/2023] [Indexed: 12/28/2023]
Abstract
Current recommended risk scores to predict thrombotic events associated with myeloproliferative neoplasms (MPN) do not discriminate between arterial and venous thrombosis despite their different physiopathology. To define novel stratification systems, we delineated a comprehensive landscape of MPN associated thrombosis across a large long-term follow-up MPN cohort. Prior arterial thrombosis, age >60 years, cardiovascular risk factors and presence of TET2 or DNMT3A mutations were independently associated with arterial thrombosis in multivariable analysis. ARTS, an ARterial Thrombosis Score, based on these four factors, defined low- (0.37% patients-year) and high-risk (1.19% patients-year) patients. ARTS performance was superior to the two-tiered conventional risk stratification in our training cohort, across all MPN subtypes, as well as in two external validation cohorts. Prior venous thrombosis and presence of a JAK2V617F mutation with a variant allelic frequency ≥50% were independently associated with venous thrombosis. The discrimination potential of VETS, a VEnous Thrombosis Score based on these two factors, was poor, similar to the two-tiered conventional risk stratification. Our study pinpoints arterial and venous thrombosis clinico-molecular differences and proposes an arterial risk score for more accurate patients' stratification. Further improvement of venous risk scores, accounting for additional factors and considering venous thrombosis as a heterogeneous entity is warranted.
Collapse
Affiliation(s)
- Hélène Pasquer
- Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France
- INSERM UMR 944, Institut de Recherche Saint-Louis, Paris, France
| | - Rafael Daltro de Oliveira
- Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France
| | - Loic Vasseur
- Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France
| | - Juliette Soret-Dulphy
- Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France
| | - Nabih Maslah
- Université Paris Cité, APHP, Hôpital Saint-Louis, Laboratoire de Biologie Cellulaire, Paris, France
- INSERM UMR 1131, Institut de Recherche Saint-Louis, Paris, France
| | - Lin-Pierre Zhao
- Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France
| | - Clémence Marcault
- Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France
| | - Marine Cazaux
- Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France
| | - Nicolas Gauthier
- Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France
| | - Emmanuelle Verger
- Université Paris Cité, APHP, Hôpital Saint-Louis, Laboratoire de Biologie Cellulaire, Paris, France
- INSERM UMR 1131, Institut de Recherche Saint-Louis, Paris, France
| | - Nathalie Parquet
- Université Paris Cité, APHP, Hôpital Saint-Louis, Département d'hématologie et d'Immunologie, Paris, France
| | - William Vainchenker
- APHP, Hôpital Saint-Louis, Département d'hématologie et d'Immunologie, Paris, France
| | - Emmanuel Raffoux
- Université Paris Cité, APHP, Hôpital Saint-Louis, Département d'hématologie et d'Immunologie, Paris, France
| | - Valérie Ugo
- Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, CRCI2NA, Angers, France
| | - Damien Luque Paz
- Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, CRCI2NA, Angers, France
| | - Lydia Roy
- Université Paris Est Créteil, APHP, Hôpital Henri Mondor, Service d'hématologie, Créteil, France
| | - Wayne-Corentin Lambert
- Université de Bretagne Occidentale, CHU de Brest, Service d'Hématologie Biologique, Brest, France
| | - Jean-Christophe Ianotto
- Université de Bretagne Occidentale, CHU de Brest, Service d'Hématologie et d'Hémostase Clinique, Brest, France
| | - Eric Lippert
- Université de Bretagne Occidentale, CHU de Brest, Service d'Hématologie Biologique, Brest, France
| | - Stéphane Giraudier
- Université Paris Cité, APHP, Hôpital Saint-Louis, Laboratoire de Biologie Cellulaire, Paris, France
- INSERM UMR 1131, Institut de Recherche Saint-Louis, Paris, France
| | - Bruno Cassinat
- Université Paris Cité, APHP, Hôpital Saint-Louis, Laboratoire de Biologie Cellulaire, Paris, France
- INSERM UMR 1131, Institut de Recherche Saint-Louis, Paris, France
| | - Jean-Jacques Kiladjian
- Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France
- INSERM UMR 1131, Institut de Recherche Saint-Louis, Paris, France
| | - Lina Benajiba
- Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France.
- INSERM UMR 944, Institut de Recherche Saint-Louis, Paris, France.
| |
Collapse
|
5
|
Stuckey R, Ianotto JC, Santoro M, Czyż A, Encinas MMP, Gómez-Casares MT, Pereira MSN, de Nałęcz AK, Gołos A, Lewandowski K, Szukalski Ł, González-Martín JM, Sobas MA. Prediction of major bleeding events in 1381 patients with essential thrombocythemia. Int J Hematol 2023; 118:589-595. [PMID: 37660316 PMCID: PMC10615906 DOI: 10.1007/s12185-023-03650-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 09/05/2023]
Abstract
The goal of therapy in essential thrombocythemia (ET) is reducing thrombotic risk. No algorithm to predict hemorrhage risk exists. The impact ofanti-platelet, cytoreductive and anticoagulation therapies on risk of major bleeding (MB) was evaluated. MB events were retrospectively analyzed in 1381 ET from 10 European centers. There were 0.286 MB events/person-year. Neither the International Thrombosis Prognostic Score for thrombosis in essential thrombocythemia (IPSET-t) nor the revised IPSET-t (r-IPSET-t) was predictive for hemorrhage-free survival at 10 years (p = 0.092 vs p = 0.1). Ageand leukocyte count were MB risk factors, while low hemoglobin was protective. For ET with extreme thrombocytosis (ExtT) and leukocytosis cytoreduction was not protective. MB were more frequent in ET with ExtT who received anticoagulation. Antiplatelet therapy was not, while anticoagulation was a risk factor for MB (HR 3.05, p = 0.016, CI 1.23-7.56), in particular vitamin K antagonists (22.6% of those treated had a MB event, HR 2.96, p = 0.004, CI 1.41-6.22). Survival at 10 years was associated with hemorrhage (OR 2.54, p < 0.001) but not thrombosis (HR 0.95, p = 0.829). Hemorrhage has a higher risk of mortality than thrombosis. Improved risk stratification for MB is necessary. The choice of anticoagulation, cytoreduction and antiplatelet therapies is an important area of research in ET.
Collapse
Affiliation(s)
- Ruth Stuckey
- Hematology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain
| | - Jean-Christophe Ianotto
- Service d'Hématologie et d'Hémostase Clinique, Institut de Cancéro-Hématologie, Centre Hospitalier Universitaire de Brest, Brest, France
| | - Marco Santoro
- Hematology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Anna Czyż
- Department of Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Wrocław, Poland
| | - Manuel M Perez Encinas
- Hematology Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | | | | | - Krzysztof Lewandowski
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Łukasz Szukalski
- Department of Haematology CM UMK in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | | | - Marta Anna Sobas
- Department of Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Wrocław, Poland.
| |
Collapse
|
6
|
Houot R, Bay JO, Chevallier P, Choquet S, Fornecker LM, Ianotto JC, Jaccard A, Jardin F, Legros L, Lemonnier F, Park S, Pascal L, Soussain C, Gyan E. [Creating a community of heads of department to meet hospital system challenges: First experience in haematology]. Bull Cancer 2023; 110:950-954. [PMID: 37507237 DOI: 10.1016/j.bulcan.2023.06.003] [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: 04/10/2023] [Revised: 05/26/2023] [Accepted: 06/07/2023] [Indexed: 07/30/2023]
Abstract
The French hospital system crises are constantly forcing the heads of departments to adapt and find solutions for maintaining optimal patient care in a context of staff shortage. Facing these challenges, we had the desire to create a community of department heads capable of helping each other, sharing their experiences, relying on collective intelligence and, ultimately, contributing to rebuilding their hospitals from the bottom up. In this respect, we arranged a two-day seminar, which brought together fourteen heads of hematology departments who share the same desire to challenge their organizations with a collaborative approach and make them evolve. The seminar was animated by an external speaker and included many fruitful sessions, both formal and informal. Following this seminar, participants are now interested in sharing this experience with other department heads throughout the organization of "collaborative seminars of heads of department." Such seminars would serve to create a real community of department heads capable of supporting each other to improve our organizations and to generate new ideas to participate in the reconstruction of our health system from the bottom. This approach is in line with the current strategy of public services to restore a prominent role to hospital departments. We hope that our initiative will also inspire heads of departments in other specialties.
Collapse
Affiliation(s)
- Roch Houot
- CHU de Rennes, service d'hématologie, Rennes, France.
| | - Jacques-Olivier Bay
- CHU de Clermont-Ferrand, service de thérapie cellulaire et d'hématologie clinique adulte, Clermont-Ferrand, France
| | | | - Sylvain Choquet
- AP-HP, hôpital de la Pitié-Salpêtrière, Sorbonne université, service d'hématologie clinique, Paris, France
| | | | - Jean-Christophe Ianotto
- CHU de Brest, institut de cancérologie et d'hématologie, service d'hématologie clinique, Brest, France
| | - Arnaud Jaccard
- CHU de Limoges, service d'hématologie clinique et de thérapie cellulaire, Limoges, France
| | - Fabrice Jardin
- Centre Henri-Becquerel, service d'hématologie, Rouen, France
| | - Laurence Legros
- AP-HP, université PARIS-Saclay, service d'hématologie clinique, Bicêtre, France
| | - François Lemonnier
- AP-HP, groupe hospitalier Henri-Mondor, unité hémopathies lymphoïdes, Créteil, France
| | - Sophie Park
- CHU de Grenoble-Alpes, clinique universitaire d'hématologie, Grenoble, France
| | - Laurent Pascal
- Hôpital Saint-Vincent de Paul, groupement des hôpitaux de l'institut catholique de Lille, service d'onco-hématologie, Lille, France
| | | | | |
Collapse
|
7
|
Balsat M, Alcazer V, Etienne G, Huguet F, Berger M, Cayssials E, Charbonnier A, Escoffre-Barbe M, Johnson-Ansah H, Legros L, Roy L, Delmer A, Ianotto JC, Orvain C, Larosa F, Meunier M, Amé S, Andreoli A, Cony-Makhoul P, Morisset S, Tigaud I, Rea D, Nicolini FE. First-line second generation tyrosine kinase inhibitors in patients with newly diagnosed accelerated phase chronic myeloid leukemia. Leuk Res 2023; 130:107308. [PMID: 37230027 DOI: 10.1016/j.leukres.2023.107308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/04/2023] [Accepted: 05/08/2023] [Indexed: 05/27/2023]
Abstract
Accelerated phase (AP) CML at onset and have poorer prognosis than CP-CML. We hypothesize that off-license use of second generation TKI (TKI2) as front-line therapy might counterbalance this poor prognosis, with limited toxicity. In "real-life" conditions, newly diagnosed patients meeting the ELN cytological criteria for AP-CML or harboring ACA and treated with first-line TKI2 were included in this retrospective multicenter observational study. We enrolled 69 patients [69.5 % male, median age 49.5 years, median follow-up 43.5 months], segregated into hematologic AP [HEM-AP (n = 32)] and cytogenetically defined AP [ACA-AP (n = 37)]. Hematologic parameters were worse in HEM-AP [spleen size (p = 0.014), PB basophils (p < .001), PB blasts (p < .001), PB blasts+promyelocytes (p < .001), low hemoglobin levels (p < .001)]. Dasatinib was initiated in 56 % patients in HEM-AP and in 27 % in ACA-AP, nilotinib in 44 % and 73 % respectively. Response and survival do not differ, regardless of the TKI2: 81 % vs 84.3 % patients achieved CHR, 88 % vs 84 % CCyR, 73 % vs 75 % MMR respectively. The estimated 5-year PFS 91.5 % (95%CI: 84.51-99.06 %) and 5-year OS 96.84 % (95%CI: 92.61-100 %). Only BM blasts (p < 0.001) and BM blasts+promyelocytes (p < 0.001) at diagnosis negatively influenced OS. TKI2 as front-line therapy in newly diagnosed AP-CML induce excellent responses and survival, and counterbalance the negative impact of advanced disease phase.
Collapse
Affiliation(s)
- Marie Balsat
- Hematology Department, Centre Hospitalier Lyon Sud, Pierre Bénite, France; French Group of CML (Fi-LMC), Lyon, France
| | - Vincent Alcazer
- Hematology Department, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Gabriel Etienne
- Hematology Department, Institut Bergonié, Bordeaux, France; French Group of CML (Fi-LMC), Lyon, France
| | - Françoise Huguet
- Hematology Department, Institut Universitaire du Cancer, Toulouse, France; French Group of CML (Fi-LMC), Lyon, France
| | - Marc Berger
- Hematology Department, CHU Estaing, Clermont-Ferrand, France; French Group of CML (Fi-LMC), Lyon, France
| | - Emilie Cayssials
- Hematology Department, Hôpital Jean Bernard, Poitiers, France; French Group of CML (Fi-LMC), Lyon, France
| | - Aude Charbonnier
- Hematology Department, Institut Paoli Calmettes, Marseilles, France; French Group of CML (Fi-LMC), Lyon, France
| | - Martine Escoffre-Barbe
- Hematology Department, Hôpital de Pontchaillou, Rennes, France; French Group of CML (Fi-LMC), Lyon, France
| | - Hyacinthe Johnson-Ansah
- Hematology Department, Hôpital Clémenceau, Caën, France; French Group of CML (Fi-LMC), Lyon, France
| | - Laurence Legros
- Hematology Department, Hôpital Paul Brousse, Villejuif, France; French Group of CML (Fi-LMC), Lyon, France
| | - Lydia Roy
- Hematology department, Hôpital Universitaire Henri Mondor - AP-HP & Faculté de Santé - UPEC, Créteil, France; French Group of CML (Fi-LMC), Lyon, France
| | | | - Jean-Christophe Ianotto
- Hematology Department, Hôpital Morvan, Brest, France; French Group of CML (Fi-LMC), Lyon, France
| | - Corentin Orvain
- Hematology Department, Hôpital universitaire, Angers, France; French Group of CML (Fi-LMC), Lyon, France
| | - Fabrice Larosa
- Gerontology Department, Hôpital du Bocage, Dijon, France; French Group of CML (Fi-LMC), Lyon, France
| | - Mathieu Meunier
- Hematology Department, Centre Hospitalier Universitaire Grenoble Alpes, La Tronche, France; French Group of CML (Fi-LMC), Lyon, France
| | - Shanti Amé
- Hematology Department, Institut de Cancérologie Strasbourg Europe, Strasbourg, France; French Group of CML (Fi-LMC), Lyon, France
| | - Annalisa Andreoli
- Hematology Department, CH d'Argenteuil, Argenteuil, France; French Group of CML (Fi-LMC), Lyon, France
| | - Pascale Cony-Makhoul
- Hematology Department, Centre Hospitalier Annecy Genevois, Pringy, France; French Group of CML (Fi-LMC), Lyon, France
| | | | - Isabelle Tigaud
- Laboratory for Cytogenetics, Centre Hospitalier Lyon Sud, Pierre Bénite, France; French Group of CML (Fi-LMC), Lyon, France
| | - Delphine Rea
- Hematology Department, Hôpital Saint Louis, Paris, France; French Group of CML (Fi-LMC), Lyon, France
| | - Franck Emmanuel Nicolini
- Hematology Department, Centre Léon Bérard, Lyon, France; INSERM U1052, CRCL, Lyon, France; French Group of CML (Fi-LMC), Lyon, France.
| |
Collapse
|
8
|
Herbreteau L, Couturaud F, Hoffmann C, Bressollette L, Pan-Petesch B, Rio L, Lippert E, Ianotto JC. Atrial fibrillation and peripheral arterial disease define MPN patients with very high risk of thrombosis. Thromb Res 2023; 226:93-99. [PMID: 37141796 DOI: 10.1016/j.thromres.2023.04.021] [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: 08/16/2022] [Revised: 03/20/2023] [Accepted: 04/25/2023] [Indexed: 05/06/2023]
Abstract
Myeloproliferative neoplasms (MPNs) are associated with a high risk of thrombotic and hemorrhagic complications, especially in elderly patients. Atrial fibrillation (AF) and peripheral arterial disease (PAD), also frequently discovered in aging patients, are associated with similar complications. We analysed the incidence and complication rates of AF and PAD in a large cohort of MPN patients. In total, 289/1113 patients (26 %) suffered at least one of these diseases as follows: 179 (16.1 %) with AF alone, 81 with PAD alone (7.3 %) and 29 (2.6 %) with both conditions. Postdiagnosis thrombotic events were observed in 31.3 % of AF patients (p = 0.002, OR = 1.80 [1.23;2.61]), 35.8 % of PAD patients (p = 0.002, OR = 2.21[1.31;3.67]) and 62.1 % of AF/PAD patients (p < 0.0001, OR = 6.47 [2.83;15.46]) compared to 20.1 % of no-AF/no-PAD patients. Postdiagnosis hemorrhagic events were also identified in 17.9 %, 16 %, 24.1 % and 10.1 % of AF, PAD, AF/PAD, and no-AF/no-PAD patients, respectively (p = 0.003). This significantly higher risk of thrombosis/bleeding was also observed in patients <60 years old. AF and PAD were significant risk factors for both thrombotic and hemorrhagic risks in multivariate analysis. We identified AF and PAD as criteria for high risk of thrombosis, hemorrhage, and death, emphasizing the interest in early detection and efficient treatment of these conditions.
Collapse
Affiliation(s)
- Laura Herbreteau
- Service d'Hématologie et d'Hémostase Clinique, Institut de Cancéro-Hématologie, CHU de Brest, Brest, France
| | - Francis Couturaud
- Département de Médecine Interne et Pneumologie, CHU de Brest, Brest, France; INSERM, Univ Brest, CHU de Brest, UMR 1304, GETBO, Brest, France
| | - Clément Hoffmann
- Service de Médecine vasculaire, CHU de Brest, Brest, France; INSERM, Univ Brest, CHU de Brest, UMR 1304, GETBO, Brest, France
| | - Luc Bressollette
- Service de Médecine vasculaire, CHU de Brest, Brest, France; INSERM, Univ Brest, CHU de Brest, UMR 1304, GETBO, Brest, France
| | - Brigitte Pan-Petesch
- Service d'Hématologie et d'Hémostase Clinique, Institut de Cancéro-Hématologie, CHU de Brest, Brest, France; INSERM, Univ Brest, CHU de Brest, UMR 1304, GETBO, Brest, France
| | - Laetitia Rio
- Service d'Hématologie et d'Hémostase Clinique, Institut de Cancéro-Hématologie, CHU de Brest, Brest, France
| | - Eric Lippert
- Laboratoire d'Hématologie, CHU de Brest, Brest, France; France Intergroupe des syndromes Myéloprolifératifs (FIM), Paris, France
| | - Jean-Christophe Ianotto
- Service d'Hématologie et d'Hémostase Clinique, Institut de Cancéro-Hématologie, CHU de Brest, Brest, France; INSERM, Univ Brest, CHU de Brest, UMR 1304, GETBO, Brest, France; France Intergroupe des syndromes Myéloprolifératifs (FIM), Paris, France.
| |
Collapse
|
9
|
Le Gall-Ianotto C, Ficheux AS, Lippert E, Herbreteau L, Rio L, Pan-Petesch B, Misery L, Ianotto JC. Differences between aquagenic and non-aquagenic pruritus in myeloproliferative neoplasms: An observational study of 500 patients. J Eur Acad Dermatol Venereol 2023; 37:1175-1183. [PMID: 36808754 DOI: 10.1111/jdv.18990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 02/08/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Pruritus is a frequent symptom experienced by patients with myeloproliferative neoplasms (MPN). Aquagenic pruritus (AP) is the most common type. The Myeloproliferative Neoplasm-Symptom Assessment Form Total Symptom Score (MPN-SAF TSS) self-report questionnaires were distributed to MPN patients before consultations. OBJECTIVES The aim of this study was to assess clinical incidence (phenotypical evolution and response to treatment) of pruritus, especially AP, in MPN patients during their follow-ups. PATIENTS AND METHODS We collected 1444 questionnaires from 504 patients [54.4% essential thrombocythaemia (ET) patients, 37.7% polycythaemia vera (PV) patients, and 7.9% primary myelofibrosis (PMF) patients]. RESULTS Pruritus was reported by 49.8% of the patients, including 44.6% of AP patients, regardless of type of MPN or driver mutations. Patients suffering from pruritus were more symptomatic and had a higher rate of evolution into myelofibrosis/acute myeloid leukaemia (19.5% vs. 9.1%, OR = 2.42 [1.39; 4.32], p = 0.0009) than MPN patients without pruritus. Patients with AP had the highest pruritus intensity values (p = 0.008) and a higher rate of evolution (25.9% vs. 14.4%, p = 0.025, OR = 2.07) than patients with non-AP. Disappearance of pruritus was observed in only 16.7% of AP cases, compared to 31.7% of cases with other types of pruritus (p < 0.0001). Ruxolitinib and hydroxyurea were the most effective drugs to reduce AP intensity. CONCLUSIONS In this study, we demonstrate the global incidence of pruritus across all MPN. Pruritus, especially AP, which is a major constitutional symptom observed in MPN, should be assessed in all MPN patients due to higher symptom burden and higher risk of evolution.
Collapse
Affiliation(s)
| | - Anne-Sophie Ficheux
- Service de Dermatologie, CHRU de Brest, Brest, France.,Univ Brest, LIEN, CHRU Brest, Brest, France
| | - Eric Lippert
- Laboratoire d'Hématologie, CHRU de Brest, Brest, France.,France Intergroupe des Néoplasies Myéloprolifératives (FIM), Paris, France
| | - Laura Herbreteau
- Service d'Hématologie et d'Hémostase Clinique, Institut de Cancéro-Hématologie, CHRU de Brest, Brest, France
| | - Laetitia Rio
- Service d'Hématologie et d'Hémostase Clinique, Institut de Cancéro-Hématologie, CHRU de Brest, Brest, France
| | - Brigitte Pan-Petesch
- Service d'Hématologie et d'Hémostase Clinique, Institut de Cancéro-Hématologie, CHRU de Brest, Brest, France.,INSERM, Univ Brest, CHRU Brest, UMR 1304, GETBO, Brest, France
| | - Laurent Misery
- Service de Dermatologie, CHRU de Brest, Brest, France.,Univ Brest, LIEN, CHRU Brest, Brest, France
| | - Jean-Christophe Ianotto
- France Intergroupe des Néoplasies Myéloprolifératives (FIM), Paris, France.,Service d'Hématologie et d'Hémostase Clinique, Institut de Cancéro-Hématologie, CHRU de Brest, Brest, France.,INSERM, Univ Brest, CHRU Brest, UMR 1304, GETBO, Brest, France
| |
Collapse
|
10
|
Roy L, Chomel JC, Guilhot J, Guerci-Bresler A, Escoffre-Barbe M, Giraudier S, Charbonnier A, Dubruille V, Huguet F, Johnson-Ansah H, Lenain P, Ame S, Etienne G, Nicolini FE, Rea D, Cony-Makhoul P, Courby S, Ianotto JC, Legros L, Machet A, Coiteux V, Hermet E, Cayssials E, Bouchet S, Mahon FX, Rousselot P, Guilhot F. Dasatinib plus Peg-Interferon alpha 2b combination in newly diagnosed chronic phase chronic myeloid leukaemia: Results of a multicenter phase 2 study (DASA-PegIFN study). Br J Haematol 2023; 200:175-186. [PMID: 36214090 DOI: 10.1111/bjh.18486] [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: 05/13/2022] [Revised: 09/04/2022] [Accepted: 09/16/2022] [Indexed: 01/14/2023]
Abstract
Superior rates of deep molecular response (DMR) have been reported with the combination of tyrosine kinase inhibitors and pegylated-interferon-alpha (Peg-IFN) in patients with newly diagnosed chronic phase-chronic myeloid leukaemia (CP-CML). In this setting, this study investigated the efficacy and safety of dasatinib combined to Peg-IFN-α2b (Dasa-PegIFN, NCT01872442). A total of 79 patients (age ≤65 years) started dasatinib; 61 were eligible for Peg-IFNα-2b add-on therapy at month 3 for a maximum 21-months duration. Dasatinib was continued thereafter. The primary endpoint was the cumulative rate of molecular response 4.5 log (MR4.5 ) by 12 months. The results are reported for the 5-year duration of the study. Grade 3 neutropenia was frequent with the combination but did not induce severe infection (one of grade 3). Other adverse events were generally low grade (4% of grade 3-4) and expected. Seventy-nine per cent and 61% of patients continued the Peg-IFN until months 12 and 24, respectively. Overall, at these time points, MR4.5 rates were 25% and 38%, respectively. Thereafter, 32% and 46% of patients achieved a sustained (≥2 years) MR4.5 or MR4 , respectively. This work established the feasibility and high rates of achievement of early and sustained DMR (a prerequisite for treatment-free-remission) with dasatinib and Peg-IFNα-2b combination as initial therapy.
Collapse
Affiliation(s)
- Lydia Roy
- Hôpital Universitaire Henri Mondor, APHP, Faculté de Santé, UPEC, Service d'Hématologie Clinique, Créteil, France
| | | | | | | | | | - Stéphane Giraudier
- Hôpital Saint-Louis, APHP et INSERM Université de Paris, Service de biologie cellulaire, Paris, France
| | - Aude Charbonnier
- Institut Paoli-Calmettes, Service d'Hématologie Clinique, Marseille, France
| | | | - Françoise Huguet
- Service d'Hématologie Clinique, CHU Toulouse, I.U.C.T.O, Toulouse, France
| | | | - Pascal Lenain
- Centre Henri Becquerel, Service d'Hématologie Clinique, Rouen, France
| | - Shanti Ame
- CHU Strasbourg, Service d'Hématologie Clinique, Strasbourg, France
| | - Gabriel Etienne
- Institut Bergonié, Service d'Hématologie Clinique, Bordeaux, France
| | - Franck E Nicolini
- Centre Léon Bérard, Service d'Hématologie Clinique & INSERM U1052 CRC, Lyon, France
| | - Delphine Rea
- Hôpital St Louis, APHP, Service d'Hématologie Clinique, Paris, France
| | | | - Stéphane Courby
- CHU Grenoble Service d'Hématologie Clinique, Grenoble, France
| | | | - Laurence Legros
- Hôpital Paul Brousse, AP-HP, Service d'Hématologie Clinique, INSERM UMRS-MD1197, Villejuif, France
| | - Antoine Machet
- Hôpital Bretonneau, CHRU Tours Service d'Hématologie Clinique, Tours, France
| | - Valérie Coiteux
- Hôpital Claude Huriez, CHRU Lille Service d'Hématologie Clinique, Lille, France
| | - Eric Hermet
- CHU d'Estaing, Clermont-Ferrand, Service d'Hématologie Clinique, Clermont-Ferrand, France
| | - Emilie Cayssials
- INSERM CIC 1402, CHU Poitiers, Poitiers, France.,CHU de Poitiers, Service d'Hématologie Clinique, Poitiers, France
| | - Stéphane Bouchet
- Hôpital Pellegrin, CHU Bordeaux, Laboratoire de pharmacologie, Bordeaux, France
| | | | - Philippe Rousselot
- Centre Hospitalier de Versailles, Université Paris Saclay UMR 1184, Service d'Hématologie Clinique, Le Chesnay, France
| | | | -
- French CML group (Fi-LMC), Centre Léon Bérard, Lyon, France
| |
Collapse
|
11
|
Stuckey R, Ianotto JC, Santoro M, Czyż A, Perez Encinas MM, Gómez-Casares MT, Noya Pereira MS, de Nałęcz AK, Gołos A, Lewandowski K, Szukalski Ł, González-Martín JM, Wróbel T, Sobas MA. Validation of thrombotic risk factors in 1381 patients with essential thrombocythaemia: A multicentre retrospective real-life study. Br J Haematol 2022; 199:86-94. [PMID: 35906782 DOI: 10.1111/bjh.18387] [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] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/07/2022] [Accepted: 07/17/2022] [Indexed: 11/29/2022]
Abstract
Thrombosis and haemorrhage are frequent in patients with essential thrombocythaemia (ET). The 2016 revised International Prognostic Score for Thrombosis in Essential Thrombocythaemia-thrombosis (r-IPSET-t) score stratifies patients into very-low- (VLR), low- (LR), intermediate- (IR) and high-risk (HR) groups. We validated the r-IPSET-t in the biggest population of patients with ET (n = 1381) to date and found it to be a better fit than the earlier IPSET-t score. With an average follow-up of 87.7 months, there were 0.578 thrombotic events/person-year and 0.286 bleeding events/person-year after diagnosis. The 10-year thrombosis-free survival was 88% and 99% for the r-IPSET-t LR and VLR groups (p < 0.001). Cytoreduction was a thrombotic risk factor in younger patients (aged <60 years, hazard ratio 9.49, p = 0.026; aged ≥60 years, hazard ratio 1.04, p = 0.93). In multivariable Cox regression analysis, anti-aggregation after diagnosis was protective for thrombosis (hazard ratio 0.31, p = 0.005) but a risk factor for major bleeding (hazard ratio 10.56, p = 0.021). Of the IPSET-t HR and LR groups, 132/780 and 249/301 were re-classified as LR and VLR respectively (p < 0.001). The European LeukemiaNET (ELN) does not recommend aspirin for VLR patients but in this real-life analysis 83.1% of VLR patients received it. Our results validate the r-IPSET-t score as more predictive for thrombosis than the ELN-recommended IPSET-t and raise concerns about unnecessary cytoreductive and anti-aggregative therapy.
Collapse
Affiliation(s)
- Ruth Stuckey
- Hematology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain
| | - Jean-Christophe Ianotto
- Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, Centre Hospitalier Régional et Universitaire de Brest, Brest, France
| | - Marco Santoro
- Hematology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Anna Czyż
- Department of Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Manuel M Perez Encinas
- Hematology Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | | | - Aleksandra Gołos
- Department of Hematology, Institute of Hematology, Warsaw, Poland
| | - Krzysztof Lewandowski
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Łukasz Szukalski
- Department of Haematology CM UMK in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | | | - Tomasz Wróbel
- Department of Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Marta Anna Sobas
- Department of Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| |
Collapse
|
12
|
Lemoine S, Mornet C, Quintin-Roue I, Rousselet MC, Cottin L, Georgeais A, Dubouis L, Boyer F, Orvain C, Caillon C, Renard M, Le Brun V, Le Clech L, Ianotto JC, Génin E, Burroni B, Ugo V, Paz DL, Lippert E. Histological, genetic characterization and follow-up of 130 patients with chronic triplenegative thrombocytosis. Haematologica 2022; 107:2725-2731. [PMID: 35833299 PMCID: PMC9614530 DOI: 10.3324/haematol.2022.280917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Sandrine Lemoine
- Laboratoire d'Hématologie, CHU Angers, Angers, France; Université d'Angers, Inserm UMR 1307, CNRS UMR 6075, Nantes Université, CRCI2NA, Angers, France; Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), France; France Intergroupe des Syndromes Myéloprolifératifs (FIM)
| | - Clelia Mornet
- France Intergroupe des Syndromes Myéloprolifératifs (FIM); Laboratoire d'Hématologie, CHRU Brest, Brest
| | | | | | - Laurane Cottin
- Laboratoire d'Hématologie, CHU Angers, Angers, France; Université d'Angers, Inserm UMR 1307, CNRS UMR 6075, Nantes Université, CRCI2NA, Angers, France; Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), France; France Intergroupe des Syndromes Myéloprolifératifs (FIM)
| | | | | | - Françoise Boyer
- Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), France; France Intergroupe des Syndromes Myéloprolifératifs (FIM); Service des Maladies du Sang, CHU Angers, Angers
| | - Corentin Orvain
- Université d'Angers, Inserm UMR 1307, CNRS UMR 6075, Nantes Université, CRCI2NA, Angers, France; Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), France; France Intergroupe des Syndromes Myéloprolifératifs (FIM); Service des Maladies du Sang, CHU Angers, Angers
| | - Clara Caillon
- Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), France; Service des Maladies du Sang, CHU Angers, Angers
| | - Maxime Renard
- Laboratoire d'Hématologie, CHU Angers, Angers, France; Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL)
| | - Valoris Le Brun
- Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), France; Laboratoire d'Hématologie, CHRU Brest, Brest
| | | | - Jean-Christophe Ianotto
- Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), France; France Intergroupe des Syndromes Myéloprolifératifs (FIM); Service d'Hématologie Clinique, CHRU Brest, Brest, France; Univ Brest, Inserm, GETBO, Brest
| | | | - Barbara Burroni
- France Intergroupe des Syndromes Myéloprolifératifs (FIM); Service de pathologie, AP-HP, Hôpital Cochin, F-75014 Paris, France; Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Paris
| | - Valérie Ugo
- Laboratoire d'Hématologie, CHU Angers, Angers, France; Université d'Angers, Inserm UMR 1307, CNRS UMR 6075, Nantes Université, CRCI2NA, Angers, France; Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), France; France Intergroupe des Syndromes Myéloprolifératifs (FIM)
| | - Damien Luque Paz
- Laboratoire d'Hématologie, CHU Angers, Angers, France; Université d'Angers, Inserm UMR 1307, CNRS UMR 6075, Nantes Université, CRCI2NA, Angers, France; Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), France; France Intergroupe des Syndromes Myéloprolifératifs (FIM)
| | - Eric Lippert
- Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), France; France Intergroupe des Syndromes Myéloprolifératifs (FIM); Laboratoire d'Hématologie, CHRU Brest, Brest, France; Univ Brest, Inserm, EFS, UMR 1078, GGB, Brest
| |
Collapse
|
13
|
Herbreteau L, Papageorgiou L, Le Clech L, Garcia G, James C, Pan-Petesch B, Couturaud F, Gerotziafas G, Lippert E, Ianotto JC. Benefice and pitfall of direct oral anticoagulants in very high-risk myeloproliferative neoplasms. Thromb Res 2022; 216:25-34. [DOI: 10.1016/j.thromres.2022.05.015] [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] [Received: 03/07/2022] [Revised: 04/30/2022] [Accepted: 05/30/2022] [Indexed: 10/18/2022]
|
14
|
Rio L, Monceau-Baroux L, Ianotto JC. [Expectations of private nurses in the care management of oncology and haematology patients]. Soins 2022; 67:44-47. [PMID: 36127022 DOI: 10.1016/j.soin.2022.05.031] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Toxicities from chemotherapy administered in an outpatient department occur mostly when patients return home. Support treatment prescriptions are given to them in order to prevent or limit these toxicities. The cancer plans also specify the need for collaboration between the city and the hospital. In this sense, it is interesting to take stock of the knowledge of private nurses caring for these patients and to identify their expectations.
Collapse
Affiliation(s)
- Laetitia Rio
- Service d'hématologie clinique,Institut de cancérologie et d'hématologie, Centre hospitalier régional universitaire de Brest, 2 avenue Maréchal-Foch, 29200 Brest, France.
| | - Lucie Monceau-Baroux
- Service d'oncologie médicale, Institut de cancérologie et d'hématologie, Centre hospitalier régional universitaire de Brest, 2 avenue Maréchal-Foch, 29200 Brest, France
| | - Jean-Christophe Ianotto
- Service d'hématologie clinique,Institut de cancérologie et d'hématologie, Centre hospitalier régional universitaire de Brest, 2 avenue Maréchal-Foch, 29200 Brest, France
| |
Collapse
|
15
|
Dulucq S, Nicolini FE, Rea D, Cony-Makhoul P, Charbonnier A, Escoffre-Barbe M, Coiteux V, Lenain P, Rigal-Huguet F, Liu J, Guerci-Bresler A, Legros L, Ianotto JC, Gardembas M, Turlure P, Dubruille V, Rousselot P, Martiniuc J, Jardel H, Johnson-Ansah H, Joly B, Henni T, Cayssials E, Zunic P, Berger MG, Villemagne B, Robbesyn F, Morisset S, Mahon FX, Etienne G. Kinetics of early and late molecular recurrences after first-line imatinib cessation in chronic myeloid leukemia: updated results from the STIM2 trial. Haematologica 2022; 107:2859-2869. [PMID: 35615931 PMCID: PMC9713567 DOI: 10.3324/haematol.2022.280811] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Indexed: 12/14/2022] Open
Abstract
Discontinuation of tyrosine kinase inhibitors in chronic phase chronic myeloid leukemia is feasible in clinical practice based on recently published international recommendations. Nevertheless, factors predictive of molecular recurrence have not been fully elucidated and long-term follow-up of patients enrolled in clinical studies are required in order to update knowledge on discontinuation attempts particularly in terms of the safety and durability of treatment-free remission (TFR). In the current study, we updated results from the STIM2 study in the light of the consensual criterion of molecular recurrence reported in different international recommendations. Among the 199 patients included in the perprotocol study, 108 patients lost a major molecular response. With a median follow-up of 40.8 months (5.5-111 months), the probability of treatment-free remission was 43.4% [36.3-50.4] at 5 years, 40.9% [32.8-47.3] at 7 years and 34.5% [25.6- 43.3] at 9 years. Molecular recurrence occurred between 0 to 6 months, 6 to 24 months and after 24 months in 75 patients (69%), 15 patients (14%) and 18 patients (17%), respectively. Notably, the kinetics of molecular recurrence differed significantly between these three subgroups with a median time from loss of MR4 (BCR::ABL1 IS≤0.01%) to loss of major molecular response of 1, 7 and 22 months, respectively. Predictive factors of molecular recurrence differed according to the time of occurrence of the molecular recurrence. Durations of imatinib treatment and deep molecular response as well as BCR::ABL1/ABL1 levels at cessation of tyrosine kinase inhibitor treatment, as quantified by reverse transcriptase droplet digital polymerase chain reaction, are involved in molecular recurrence occurring up to 24 months but not beyond. (ClinicalTrial. gov Identifier NCT#0134373).
Collapse
Affiliation(s)
- Stéphanie Dulucq
- Laboratory of Hematology, University Hospital of Bordeaux, Hôpital Haut Lévêque, Pessac,Groupe Fi-LMC, Centre Léon Bérard, Lyon,S. Dulucq
| | - Franck E. Nicolini
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,INSERM U1052, Centre de Recherche de Cancérologie de Lyon, Centre Léon Bérard, Lyon,Hematology Department, Centre Léon Bérard, Lyon
| | - Delphine Rea
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Adult Hematology Department, Hôpital Saint Louis, Paris
| | - Pascale Cony-Makhoul
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department & Clinical Investigation Center, Centre Hospitalier Annecy-Genevois, Metz-Tessy, Pringy
| | - Aude Charbonnier
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, Institut Paoli-Calmettes, Marseilles
| | - Martine Escoffre-Barbe
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, CHU de Pontchaillou, Rennes
| | - Valérie Coiteux
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, CHU Huriez, Lille
| | - Pascal Lenain
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, Institut Henri Becquerel, Rouen
| | - Françoise Rigal-Huguet
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, Institut Universitaire du Cancer, CHU de Toulouse, Toulouse
| | - Jixing Liu
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology & Oncology Department, Centre Hospitalier de Valence, Valence
| | - Agnès Guerci-Bresler
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, CHRU Brabois, Nancy
| | - Laurence Legros
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, Hôpital Bicêtre, Le Kremlin-Bicêtre
| | | | - Martine Gardembas
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, CHU, Angers
| | - Pascal Turlure
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, CHU Dupuytren, Limoges
| | - Viviane Dubruille
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, Hôtel Dieu, Nantes
| | - Philippe Rousselot
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, Centre Hospitalier de Versailles, Le Chesnay
| | - Juliana Martiniuc
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, Centre Hospitalier de Saint Brieuc, Saint Brieuc
| | - Henry Jardel
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, Centre Hospitalier de Bretagne, Vannes
| | - Hyacinthe Johnson-Ansah
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Institute of Normandy, CHU de la Côte de Nacre, Caën
| | - Bertrand Joly
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, CH Sud Francilien, Corbeil-Essonne
| | - Tawfiq Henni
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, CHR La Réunion
| | - Emilie Cayssials
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, CHU de Poitiers, Poitiers
| | - Patricia Zunic
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, Centre Hospitalier, Saint Pierre de La Réunion
| | - Marc G. Berger
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology (Biology) Department, CHU Estaing, Clermont-Ferrand
| | - Bruno Villemagne
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Internal Medicine and Onco-hematology Department, La Roche sur Yon and
| | - Fanny Robbesyn
- Laboratory of Hematology, University Hospital of Bordeaux, Hôpital Haut Lévêque, Pessac
| | - Stephane Morisset
- INSERM U1052, Centre de Recherche de Cancérologie de Lyon, Centre Léon Bérard, Lyon
| | - François-Xavier Mahon
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, Institut Bergonié, Bordeaux, France,F-XM and GE contributed equally as co-senior authors
| | - Gabriel Etienne
- Groupe Fi-LMC, Centre Léon Bérard, Lyon,Hematology Department, Institut Bergonié, Bordeaux, France,F-XM and GE contributed equally as co-senior authors
| |
Collapse
|
16
|
Nicol C, Ajzenberg N, Lacut K, Couturaud F, Pan-Petesch B, Lippert E, Ianotto JC. Hemorrhages in polycythemia vera and essential thrombocythemia: epidemiology, description, and risk factors, learnings from a large cohort. Thromb Haemost 2022; 122:1712-1722. [PMID: 35545123 DOI: 10.1055/a-1849-8477] [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: 10/18/2022]
Abstract
BACKGROUND The management of myeloproliferative neoplasms (MPN) is based on the reduction of thrombosis risk. The incidence, impact, and risk factors of bleedings have been less studied. METHOD All patients with polycythemia vera (n=339) or essential thrombocythemia (n=528) treated in our center are included in OBENE cohort (NCT02897297). Major bleeding (MB) and clinically relevant non-major bleeding (CRNMB) occurring after diagnosis were included, except after leukemic transformation. RESULTS With a median follow-up of 8.3 years, incidence of hemorrhages was 1.85% patient/year, with an incidence of MB of 0.95% patient/year. The 10-year bleeding-free survival was 89%. The most frequent locations were digestive tractus, "mouth, nose and throat" and muscular hematoma. The case fatality rate of MB was 25%. The proportion of potentially avoidable iatrogenic bleeding was remarkable (17.6%). In multivariable analysis, eight risk factors of bleeding were identified: leukocytes >20 giga/l at diagnosis (HR=5.13 95%CI [1.77;14.86]), secondary hemopathies (HR=2.99 95%CI [1.27;7.04]), aspirin use at diagnosis (HR=2.11 95%CI [1.24;3.6]), platelet count >1000 giga/l at diagnosis (HR=1.93, 95%CI [1.11;3.36]), history of hemorrhage (HR=1.82 95%CI [1.03;3.24]), secondary cancers (HR=1.71 95%CI [1.01;2.89]), atrial fibrillation (HR=1.66, 95%CI [1.01;2.72]) and male gender (HR=1.54, 95%CI [1.02-2.33]). The majority of patients taking hydroxyurea displayed a non-macrocytic median corpuscular value in the months preceding bleeding (51.4%). DISCUSSION The morbidity and mortality of bleedings in MPN should not be underestimated, and some patients could beneficiate from cytoreduction in order to reducing bleeding risk. Iatrogenic bleedings represent a substantial proportion of bleeding and could be better prevented.
Collapse
Affiliation(s)
| | | | - Karine Lacut
- CIC1412, Inserm, Brest, France.,EA 3878, Brest University, Brest, France
| | - Francis Couturaud
- Department of internal medicine and chest diseases, Brest University Hospital Centre, Brest, France
| | | | - Eric Lippert
- Laboratoire d'Hématologie, CHU de Brest, Brest, France.,Equipe ECLA, INSERM U1078, France
| | | |
Collapse
|
17
|
Tefferi A, Ianotto JC, Mathews V, Samuelsson J, Szuber N, Xiao Z, Hokland P. Myeloproliferative neoplasms - a global view. Br J Haematol 2022; 198:953-964. [PMID: 35482584 DOI: 10.1111/bjh.18213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/12/2022] [Accepted: 04/12/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Ayalew Tefferi
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Vikram Mathews
- Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Jan Samuelsson
- Department of Hematology, Linköping University Hospital, Linköping, Sweden
| | - Natasha Szuber
- Department of Hematology, Maisonneuve-Rosemont Hospital, Montreal, Canada
| | - Zhijian Xiao
- MDS and MPN Centre, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Peter Hokland
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
18
|
Sureau L, Buors C, Ianotto JC, Boyer F, Tanguy-Schmidt A, Roy L, Cayssials E, Cailly L, Chomel JC, Chauveau A, Orvain C, Mansier O, Ranta D, Robles M, Gyan E, Hérault O, Nimubona S, Marchand T, Lippert E, Riou J, Ugo V, Luque Paz D. JAK2 V617F polycythemia vera and essential thrombocythemia: dynamic clinical features associated with long-term outcomes. Blood Cancer J 2022; 12:56. [PMID: 35395836 PMCID: PMC8993923 DOI: 10.1038/s41408-022-00646-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Léa Sureau
- CHU Angers, Laboratoire d'Hématologie, Angers, France.,Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, CRCI2NA, F-49000, Angers, France.,Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), Angers, France
| | - Caroline Buors
- Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), Angers, France.,CHU Brest, Laboratoire d'Hématologie, Brest, France
| | - Jean-Christophe Ianotto
- Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), Angers, France.,CHU Brest, Service d'Hématologie Clinique, Brest, France
| | - Françoise Boyer
- Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), Angers, France.,CHU Angers, Service des Maladies du Sang, Angers, France
| | - Aline Tanguy-Schmidt
- Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, CRCI2NA, F-49000, Angers, France.,Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), Angers, France.,CHU Angers, Service des Maladies du Sang, Angers, France
| | - Lydia Roy
- Hôpital Universitaire Henri Mondor, Service Hématologie Clinique, APHP & UPEC, UFR de Santé, Créteil, France
| | - Emilie Cayssials
- Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), Angers, France.,CHU Poitiers, Service d'Oncologie Hématologique et Thérapie Cellulaire, Poitiers, France
| | - Laura Cailly
- CHU Poitiers, Service d'Oncologie Hématologique et Thérapie Cellulaire, Poitiers, France
| | - Jean-Claude Chomel
- Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), Angers, France.,CHU Poitiers, Service de Cancérologie Biologique, Poitiers, France
| | | | - Corentin Orvain
- Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, CRCI2NA, F-49000, Angers, France.,Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), Angers, France.,CHU Angers, Service des Maladies du Sang, Angers, France
| | - Olivier Mansier
- CHU de Bordeaux, Laboratoire d'Hématologie et Université de Bordeaux, Inserm U1034, Bordeaux, France
| | - Dana Ranta
- CHU Nancy, Hématologie Clinique, Nancy, France
| | - Margot Robles
- CH Périgueux, Hématologie Clinique, Périgueux, France
| | - Emmanuel Gyan
- Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), Angers, France.,CHU Tours, Service d'Hématologie et Thérapie Cellulaire, CNRS EMR 7001 LNOx, université de Tours EA7501, Tours, France
| | - Olivier Hérault
- Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), Angers, France.,CHU Tours, Service d'Hématologie Biologique, CNRS EMR 7001 LNOx, université de Tours EA7501, Tours, France
| | - Stanislas Nimubona
- Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), Angers, France.,CHU Rennes, Service d'Hématologie Clinique, Rennes, France
| | - Tony Marchand
- Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), Angers, France.,CHU Rennes, Service d'Hématologie Clinique, Rennes, France.,INSERM U1236, Faculté de Médecine, Université Rennes 1, Rennes, France
| | - Eric Lippert
- Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), Angers, France.,CHU Brest, Laboratoire d'Hématologie, Brest, France
| | - Jérémie Riou
- CHU Angers, Département de Biostatistiques et de Méthodologie, DRCI, Angers, France.,Univ Angers, CHU Angers, Inserm, CNRS, MINT, SFR ICAT, Angers, France
| | - Valérie Ugo
- CHU Angers, Laboratoire d'Hématologie, Angers, France. .,Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, CRCI2NA, F-49000, Angers, France. .,Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), Angers, France.
| | - Damien Luque Paz
- CHU Angers, Laboratoire d'Hématologie, Angers, France. .,Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, CRCI2NA, F-49000, Angers, France. .,Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), Angers, France.
| |
Collapse
|
19
|
Lombion N, Robin P, Tempescul A, LE Roux PY, Schick U, Guillerm G, Ianotto JC, Berthou C, Salaün PY, Abgral R. Prognostic value of interim FDG PET-CT in patients older than 60 years with diffuse large B-cell lymphoma treated by PMitCEBO plus rituximab. Comparison between Deauville 5-point scale and International Harmonization Project criteria. Q J Nucl Med Mol Imaging 2021; 65:402-409. [PMID: 35133099 DOI: 10.23736/s1824-4785.16.02894-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Advanced age is an independent poor prognostic factor of diffuse large B-cell lymphoma (DLBCL). PMitCEBO (mitoxantrone, cyclophosphamide, etoposide, vincristine, bleomycin, and prednisolone) is an alternative to the cyclophosphamide, doxorubicin, vincristine, and prednisolone regimen to decrease side effects in elderly patients. Many studies have shown prognostic value of an interim FDG PET-CT to predict survival. A recent consensus (ICML, Lugano 2013) has suggested using the 5-point scale Deauville criteria instead of those of the International Harmonization Project (IHP) to visually assess the response on interim PET. The objective of this study was to evaluate the prognostic value of an interim FDG PET-CT in patients older than 60 with treated DLBCL and to compare IHP and 5-PS Deauville visual interpretation to predict survival. METHODS Forty-eight patients (mean age 73.2±5.2 years) treated by R-PMitCEBO for DLBCL undergoing FDG PET-CT before and after 3 cycles of treatment were retrospectively included. Event-free survival and overall survival were determined by Kaplan-Meier method and compared with interim PET-CT results using IHP and 5-PS Deauville criteria. RESULTS Interim PET results using 5-PS Deauville criteria were significantly correlated with EFS (P<0.0001) and OS (P=0.001) whereas they were moderately correlated with EFS (P=0.046) and not with OS (P=0.106) using IHP criteria. Two-year EFS and OS rates were 86.5% and 89.2%, respectively, for patients in 1-3 score group, and 27.3% and 36.4%, respectively, for patients in ≥4 score group using the Deauville criteria. CONCLUSIONS Our results confirmed the prognostic value of an interim PET-CT in elderly patients with DLBCL and the better performance of the 5-PS Deauville criteria.
Collapse
Affiliation(s)
- Naelle Lombion
- Department of Hematology, University Hospital of Brest, Brest, France
| | - Philippe Robin
- Department of Nuclear Medicine, University Hospital of Brest, Brest, France
| | - Adrian Tempescul
- Department of Hematology, University Hospital of Brest, Brest, France
| | | | - Ulrike Schick
- Department of Oncology-Radiotherapy, University Hospital of Brest, Brest, France
| | - Gaëlle Guillerm
- Department of Hematology, University Hospital of Brest, Brest, France
| | | | - Christian Berthou
- Department of Hematology, University Hospital of Brest, Brest, France
| | - Pierre-Yves Salaün
- Department of Nuclear Medicine, University Hospital of Brest, Brest, France
| | - Ronan Abgral
- Department of Nuclear Medicine, University Hospital of Brest, Brest, France -
| |
Collapse
|
20
|
Luque Paz D, Cottin L, Lippert E, Robin JB, Bescond C, Genevieve F, Boyer F, Quintin-Roue I, Rousselet MC, Burroni B, Hunault-Berger M, Ugo V, Ianotto JC, Orvain C. Different number of circulating CD34 + cells in essential thrombocythemia, prefibrotic/early primary myelofibrosis, and overt primary myelofibrosis. Ann Hematol 2021; 101:893-896. [PMID: 34611719 DOI: 10.1007/s00277-021-04672-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/19/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Damien Luque Paz
- Laboratoire d'Hématologie, CHU d'Angers, 49000, Angers, France.,Inserm, CRCINA, Univ Angers, Angers, France.,Fédération Hospitalo-Universitaire Grand-Ouest Acute Leukemia, FHU-GOAL, Angers, France
| | - Laurane Cottin
- Laboratoire d'Hématologie, CHU d'Angers, 49000, Angers, France.,Inserm, CRCINA, Univ Angers, Angers, France.,Fédération Hospitalo-Universitaire Grand-Ouest Acute Leukemia, FHU-GOAL, Angers, France
| | - Eric Lippert
- Laboratoire d'Hématologie, CHRU de Brest, Brest, France
| | - Jean-Baptiste Robin
- Service des Maladies du Sang, CHU d'Angers, 4 rue Larrey, 49933 Cedex 9, Angers, France
| | - Charles Bescond
- Service des Maladies du Sang, CHU d'Angers, 4 rue Larrey, 49933 Cedex 9, Angers, France
| | | | - Françoise Boyer
- Service des Maladies du Sang, CHU d'Angers, 4 rue Larrey, 49933 Cedex 9, Angers, France
| | | | | | | | - Mathilde Hunault-Berger
- Inserm, CRCINA, Univ Angers, Angers, France.,Fédération Hospitalo-Universitaire Grand-Ouest Acute Leukemia, FHU-GOAL, Angers, France.,Service des Maladies du Sang, CHU d'Angers, 4 rue Larrey, 49933 Cedex 9, Angers, France
| | - Valérie Ugo
- Laboratoire d'Hématologie, CHU d'Angers, 49000, Angers, France.,Inserm, CRCINA, Univ Angers, Angers, France.,Fédération Hospitalo-Universitaire Grand-Ouest Acute Leukemia, FHU-GOAL, Angers, France
| | - Jean-Christophe Ianotto
- Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest, Brest, France
| | - Corentin Orvain
- Inserm, CRCINA, Univ Angers, Angers, France. .,Fédération Hospitalo-Universitaire Grand-Ouest Acute Leukemia, FHU-GOAL, Angers, France. .,Service des Maladies du Sang, CHU d'Angers, 4 rue Larrey, 49933 Cedex 9, Angers, France.
| |
Collapse
|
21
|
Bagacean C, Iuga CA, Bordron A, Tempescul A, Pralea IE, Bernard D, Cornen M, Bergot T, Le Dantec C, Brooks W, Saad H, Ianotto JC, Pers JO, Zdrenghea M, Berthou C, Renaudineau Y. Identification of altered cell signaling pathways using proteomic profiling in stable and progressive chronic lymphocytic leukemia. J Leukoc Biol 2021; 111:313-325. [PMID: 34288092 DOI: 10.1002/jlb.4hi0620-392r] [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: 11/09/2022] Open
Abstract
Chronic lymphocytic leukemia (CLL) is characterized by significant biologic and clinical heterogeneity. This study was designed to explore CLL B-cells' proteomic profile in order to identify biologic processes affected at an early stage and during disease evolution as stable or progressive. Purified B cells from 11 untreated CLL patients were tested at two time points by liquid chromatography-tandem mass spectrometry. Patients included in the study evolved to either progressive (n = 6) or stable disease (n = 5). First, at an early stage of the disease (Binet stage A), based on the relative abundance levels of 389 differentially expressed proteins (DEPs), samples were separated into stable and progressive clusters with the main differentiating factor being the RNA splicing pathway. Next, in order to test how the DEPs affect RNA splicing, a RNA-Seq study was conducted showing 4217 differentially spliced genes between the two clusters. Distinct longitudinal evolutions were observed with predominantly proteomic modifications in the stable CLL group and spliced genes in the progressive CLL group. Splicing events were shown to be six times more frequent in the progressive CLL group. The main aberrant biologic processes controlled by DEPs and spliced genes in the progressive group were cytoskeletal organization, Wnt/β-catenin signaling, and mitochondrial and inositol phosphate metabolism with a downstream impact on CLL B-cell survival and migration. This study suggests that proteomic profiles at the early stage of CLL can discriminate progressive from stable disease and that RNA splicing dysregulation underlies CLL evolution, which opens new perspectives in terms of biomarkers and therapy.
Collapse
Affiliation(s)
- Cristina Bagacean
- Univ Brest, INSERM, UMR1227, B Lymphocytes and Autoimmunity, Brest, France.,Department of Hematology, University Hospital of Brest, Brest, France
| | - Cristina Adela Iuga
- Department of Drug Analysis, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Proteomics and Metabolomics, MedFuture Research Center for Advanced Medicine-MedFUTURE, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Anne Bordron
- Univ Brest, INSERM, UMR1227, B Lymphocytes and Autoimmunity, Brest, France
| | - Adrian Tempescul
- Univ Brest, INSERM, UMR1227, B Lymphocytes and Autoimmunity, Brest, France.,Department of Hematology, University Hospital of Brest, Brest, France
| | - Ioana-Ecaterina Pralea
- Department of Proteomics and Metabolomics, MedFuture Research Center for Advanced Medicine-MedFUTURE, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Melanie Cornen
- Univ Brest, INSERM, UMR1227, B Lymphocytes and Autoimmunity, Brest, France
| | | | | | - Wesley Brooks
- Department of Chemistry, University of South Florida, Tampa, Florida, USA
| | - Hussam Saad
- Department of Hematology, University Hospital of Brest, Brest, France
| | | | | | - Mihnea Zdrenghea
- "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Christian Berthou
- Univ Brest, INSERM, UMR1227, B Lymphocytes and Autoimmunity, Brest, France.,Department of Hematology, University Hospital of Brest, Brest, France
| | - Yves Renaudineau
- Univ Brest, INSERM, UMR1227, B Lymphocytes and Autoimmunity, Brest, France.,Laboratory of Immunology and Immunotherapy, University Hospital of Brest, Brest, France
| |
Collapse
|
22
|
Mahe K, Couturaud F, Kerspern H, Chauveau A, Ianotto JC. Evaluation of beta-2 microglobulin, erythropoietin and tobacco use in polycythemic cases. Int J Hematol 2021; 114:222-227. [PMID: 34021850 DOI: 10.1007/s12185-021-03164-0] [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: 02/08/2021] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 01/04/2023]
Abstract
In the 2016 WHO classification, hemoglobin and hematocrit thresholds for diagnosing polycythemia vera (PV) have been lowered, increasing the number of consultations for polycythemia investigations. In PV, beta-2 microglobulin (B2m) levels are reportedly increased, whereas erythropoietin (EPO) levels are usually low. Most secondary polycythemia cases (SP) are caused by tobacco use. We decided to analyze the relevance of these three parameters in all patients seen for polycythemia investigations to help differentiate PV from SP cases. A cohort of 257 patients (123 PV; 134 SP) was identified. The median B2m level was higher for PV patients (3.16 vs 1.98 mg/l, p < 0.0001). Increased B2m levels were observed in 83.7% of PV patients (11.9% in SP). The median EPO level was lower in PV patients (4.4 vs 12.3 UI/l, p < 0.0001). Tobacco was used by 42.8% of SP patients (8% in PV, p < 0.0001). Increased B2m, low EPO and no tobacco exposure was predictive of PV (specificity and positive predictive value = 100%). Normal B2m, normal EPO and tobacco exposure was predictive of SP (positive predictive value = 100%). These simple and inexpensive parameters could be used to rapidly differentiate PV from SP cases, before prescribing time-consuming JAK2 V617F mutation analysis by specialists.
Collapse
Affiliation(s)
- Kristell Mahe
- Hématologie Clinique, CH Cornouaille, Quimper, France
| | - Francis Couturaud
- Département de Médecine Interne Et de Pneumologie, CHRU de Brest, Brest, France.,EA3878 GETBO, Groupe D'Etude de La Thrombose en Bretagne Occidentale, Brest, France
| | | | - Aurélie Chauveau
- Laboratoire D'Hématologie, CHRU de Brest, Brest, France.,FIM, France Intergroupe Des Syndromes Myéloprolifératifs, Paris, France
| | - Jean-Christophe Ianotto
- EA3878 GETBO, Groupe D'Etude de La Thrombose en Bretagne Occidentale, Brest, France. .,FIM, France Intergroupe Des Syndromes Myéloprolifératifs, Paris, France. .,Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest, Brest, France.
| |
Collapse
|
23
|
Jouzier C, Hamel JF, Dumas PY, Delaunay J, Bonmati C, Guièze R, Hunault M, Banos A, Lioure B, Béné MC, Ianotto JC, Ojeda-Uribe M, Paul F, Bernard M, Jourdan E, Zerazhi H, Vey N, Ifrah N, Recher C, Pigneux A, Cahn JY. Conventional chemotherapy for acute myeloid leukemia in older adults: Impact on nutritional, cognitive, and functional status. Eur J Haematol 2021; 106:859-867. [PMID: 33733520 DOI: 10.1111/ejh.13624] [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: 12/07/2020] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The impact of conventional treatment for acute myeloid leukemia (AML) on the nutritional, cognitive, and functional status of elderly patients is seldom studied. This assessment was performed in the context of the LAMSA 2007 trial. METHODS The trial enrolled 424 patients with de novo AML. Among them, 316 benefited from geriatric assessment (GA) including nutritional, cognitive, and functional status and were scored according to Eastern Cooperative Oncology Group (ECOG) and sorror for the prediction of treatment toxicity, morbidity, and mortality. Patients were investigated at diagnosis for three times during follow-up. RESULTS This study showed that AML and its treatment have no impact on cognitive (P = .554) nor functional status (P = .842 for Activity of Daily Living and P = .087 for Instrumental Activities of Daily Living). The nutritional status improved over time (P = .041). None of these three parameters at baseline, associated or not with ECOG and sorror scores, impacted survivals or toxicities. CONCLUSIONS The cognitive, functional, and nutritional status had no impact in this cohort of fit elderly AML patients without unfavorable cytogenetics. The GA tools used provided no additional information compared with ECOG and sorror scores, to predict toxicity, morbidity, or mortality due to intensive chemotherapy.
Collapse
Affiliation(s)
- Claire Jouzier
- Clinical Hematology, Grenoble University Hospital, Grenoble, France
| | | | - Pierre-Yves Dumas
- Clinical Hematology, Bordeaux University Hospital, Bordeaux University, Inserm 1035, Bordeaux, France
| | | | | | - Romain Guièze
- Clinical Hematology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Mathilde Hunault
- Clinical Hematology, Angers University Hospital & INSERM U 892/CNRS 6299, Angers, France
| | - Anne Banos
- Clinical Hematology, Cote Basque General Hospital, Bayonne, France
| | - Bruno Lioure
- Clinical Hematology, Strasbourg University Hospital, Strasbourg, France
| | | | | | | | - Franciane Paul
- Clinical Hematology, Montpellier University Hospital, Montpellier, France
| | - Marc Bernard
- Clinical Hematology, Rennes University Hospital, Rennes, France
| | - Eric Jourdan
- Clinical Hematology, Nîmes University Hospital, Nîmes, France
| | - Hacène Zerazhi
- Clinical Hematology, Avignon General Hospital, Avignon, France
| | - Norbert Vey
- Clinical Hematology, Paoli-Calmettes Institute, Marseille, France
| | - Norbert Ifrah
- Clinical Hematology, Angers University Hospital & INSERM U 892/CNRS 6299, Angers, France
| | - Christian Recher
- Clinical Hematology, Toulouse University Hospital, Cancer University Institute Toulouse Oncopole, Paul Sabatier University, Toulouse, France
| | - Arnaud Pigneux
- Clinical Hematology, Bordeaux University Hospital, Bordeaux University, Inserm 1035, Bordeaux, France
| | - Jean-Yves Cahn
- Clinical Hematology, Grenoble University Hospital, Grenoble, France
| | | |
Collapse
|
24
|
Barbui T, De Stefano V, Carobbio A, Iurlo A, Alvarez-Larran A, Cuevas B, Ferrer Marín F, Vannucchi AM, Palandri F, Harrison C, Sibai H, Griesshammer M, Bonifacio M, Elli EM, Trotti C, Koschmieder S, Carli G, Benevolo G, Ianotto JC, Goel S, Falanga A, Betti S, Cattaneo D, Arellano-Rodrigo E, Mannelli L, Vianelli N, Doyle A, Gupta V, Wille K, Tremblay D, Mascarenhas J. Direct oral anticoagulants for myeloproliferative neoplasms: results from an international study on 442 patients. Leukemia 2021; 35:2989-2993. [PMID: 34012132 PMCID: PMC8132485 DOI: 10.1038/s41375-021-01279-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/14/2021] [Accepted: 04/29/2021] [Indexed: 02/06/2023]
Affiliation(s)
- Tiziano Barbui
- grid.460094.f0000 0004 1757 8431FROM Research Foundation, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Valerio De Stefano
- grid.8142.f0000 0001 0941 3192Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University, Policlinico Universitario “A. Gemelli” IRCCS, Roma, Italy
| | - Alessandra Carobbio
- grid.460094.f0000 0004 1757 8431FROM Research Foundation, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Alessandra Iurlo
- grid.414818.00000 0004 1757 8749Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
| | | | | | | | - Alessandro M. Vannucchi
- grid.8404.80000 0004 1757 2304CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms, University of Florence, AOU Careggi, Firenze, Italy
| | - Francesca Palandri
- grid.6292.f0000 0004 1757 1758Institute of Hematology “L. & A. Seragnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Claire Harrison
- grid.420545.2Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Hassan Sibai
- grid.415224.40000 0001 2150 066XPrincess Margaret Cancer Centre, Toronto, ON Canada
| | - Martin Griesshammer
- grid.5570.70000 0004 0490 981XJohannes Wesling Medical Center, University of Bochum, Bochum, Germany
| | - Massimiliano Bonifacio
- grid.5611.30000 0004 1763 1124Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Elena M. Elli
- grid.415025.70000 0004 1756 8604Hematology Division and Bone Marrow Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Chiara Trotti
- grid.8982.b0000 0004 1762 5736Dipartimento di Medicina Molecolare, Università degli Studi di Pavia, Pavia, Italy
| | - Steffen Koschmieder
- grid.1957.a0000 0001 0728 696XFaculty of Medicine, Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, RWTH Aachen University, Aachen, Germany
| | - Giuseppe Carli
- grid.416303.30000 0004 1758 2035Ospedale San Bortolo, Vicenza, Italy
| | - Giulia Benevolo
- Hematology, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Jean-Christophe Ianotto
- grid.411766.30000 0004 0472 3249Service d’Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest, Brest, France
| | - Swati Goel
- grid.240283.f0000 0001 2152 0791Albert Einstein Montefiore Medical Center, New York, NY USA
| | - Anna Falanga
- grid.460094.f0000 0004 1757 8431ASST Papa Giovanni XXIII, Bergamo, Italy ,grid.7563.70000 0001 2174 1754School of Medicine, University of Milan Bicocca, Monza, Italy
| | - Silvia Betti
- grid.8142.f0000 0001 0941 3192Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University, Policlinico Universitario “A. Gemelli” IRCCS, Roma, Italy
| | - Daniele Cattaneo
- grid.414818.00000 0004 1757 8749Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
| | | | - Lara Mannelli
- grid.8404.80000 0004 1757 2304CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms, University of Florence, AOU Careggi, Firenze, Italy
| | - Nicola Vianelli
- grid.6292.f0000 0004 1757 1758Institute of Hematology “L. & A. Seragnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrew Doyle
- grid.420545.2Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Vikas Gupta
- grid.415224.40000 0001 2150 066XPrincess Margaret Cancer Centre, Toronto, ON Canada
| | - Kai Wille
- grid.5570.70000 0004 0490 981XJohannes Wesling Medical Center, University of Bochum, Bochum, Germany
| | - Douglas Tremblay
- grid.59734.3c0000 0001 0670 2351Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - John Mascarenhas
- grid.59734.3c0000 0001 0670 2351Icahn School of Medicine at Mount Sinai, New York, NY USA
| |
Collapse
|
25
|
Bagacean C, Cousin I, Ubertini AH, El Yacoubi El Idrissi M, Bordron A, Mercadie L, Garcia LC, Ianotto JC, De Vries P, Berthou C. Simulated patient and role play methodologies for communication skills and empathy training of undergraduate medical students. BMC Med Educ 2020; 20:491. [PMID: 33276777 PMCID: PMC7716460 DOI: 10.1186/s12909-020-02401-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 11/24/2020] [Indexed: 05/06/2023]
Abstract
BACKGROUND Verbal and non-verbal communication, as well as empathy are central to patient-doctor interactions and have been associated with patients' satisfaction. Non-verbal communication tends to override verbal messages. The aim of this study was to analyze how medical students use verbal and non-verbal communication using two different educational approaches, student role play (SRP) and actor simulated patient (ASP), and whether the non-verbal behaviour is different in the two different poses. METHODS Three raters evaluated 20 students playing the doctor role, 10 in the SRP group and 10 in the ASP group. The videos were analyzed with the Calgary-Cambridge Referenced Observation Guide (CCG) and, for a more accurate evaluation of non-verbal communication, we also evaluated signs of nervousness, and posture. Empathy was rated with the CARE questionnaire. Independent Mann Whitney U tests and Qhi square tests were performed for statistical analysis. RESULTS From the 6 main tasks of the CCG score, we obtained higher scores in the ASP group for the task 'Gathering information' (p = 0.0008). Concerning the 17 descriptors of the CCG, the ASP group obtained significantly better scores for 'Exploration of the patients' problems to discover the biomedical perspective' (p = 0.007), 'Exploration of the patients' problems to discover background information and context' (p = 0.0004) and for 'Closing the session - Forward planning' (p = 0.02). With respect to non-verbal behaviour items, nervousness was significantly higher in the ASP group compared to the SRP group (p < 0.0001). Concerning empathy, no differences were found between the SRP and ASP groups. CONCLUSIONS Medical students displayed differentiated verbal and non-verbal communication behaviour during the two communication skills training methodologies. These results show that both methodologies have certain advantages and that more explicit non-verbal communication training might be necessary in order to raise students' awareness for this type of communication and increase doctor-patient interaction effectiveness.
Collapse
Affiliation(s)
- Cristina Bagacean
- Univ Brest, Inserm, UMR1227, Lymphocytes B et Autoimmunité, Brest, France
- Department of Clinical Hematology, CHU de Brest, Brest University Medical School Hospital, 2 Av Foch, 29609 Brest, France
| | - Ianis Cousin
- Department of Pediatric Surgery, CHU de Brest, Brest, France
| | | | - Mohamed El Yacoubi El Idrissi
- Department of Clinical Hematology, CHU de Brest, Brest University Medical School Hospital, 2 Av Foch, 29609 Brest, France
| | - Anne Bordron
- Univ Brest, Inserm, UMR1227, Lymphocytes B et Autoimmunité, Brest, France
| | - Lolita Mercadie
- Univ Brest, Department of Humanities and Social Sciences (SHS), Brest, France
| | | | - Jean-Christophe Ianotto
- Department of Clinical Hematology, CHU de Brest, Brest University Medical School Hospital, 2 Av Foch, 29609 Brest, France
| | | | - Christian Berthou
- Univ Brest, Inserm, UMR1227, Lymphocytes B et Autoimmunité, Brest, France
- Department of Clinical Hematology, CHU de Brest, Brest University Medical School Hospital, 2 Av Foch, 29609 Brest, France
| |
Collapse
|
26
|
Nicol C, Lacut K, Pan-Petesch B, Lippert E, Ianotto JC. Hemorrhage in Essential Thrombocythemia or Polycythemia Vera: Epidemiology, Location, Risk Factors, and Lessons Learned from the Literature. Thromb Haemost 2020; 121:553-564. [PMID: 33186994 DOI: 10.1055/s-0040-1720979] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Hemorrhage is a well-known complication of essential thrombocythemia (ET) and polycythemia vera (PV), but evidence-based data on its management and prevention are lacking to help inform clinicians. In this review, appropriate published data from the past 15 years regarding bleeding epidemiology, classification, location, and risk factors are presented and discussed. Research was conducted using the Medline database. The bleeding classifications were heterogeneous among the collected studies. The median incidences of bleeding and major bleeding were 4.6 and 0.79% patients/year, in ET patients and 6.5 and 1.05% patients/year in PV patients, respectively. The most frequent location was the gastrointestinal tract. Bleeding accounted for up to 13.7% of deaths, and cerebral bleeding was the main cause of lethal hemorrhage. Thirty-nine potential risk factors were analyzed at least once, but the results were discrepant. Among them, age >60 years, bleeding history, splenomegaly, myeloproliferative neoplasm subtype, and platelet count should deserve more attention in future studies. Among the treatments, aspirin seemed to be problematic for young patients with ET (especially CALR-mutated ET patients) and anagrelide was also identified as a bleeding inducer, especially when associated with aspirin. Future studies should analyze bleeding risk factors in more homogeneous populations and with common bleeding classifications. More tools are needed to help clinicians manage the increased risk of potentially lethal bleeding events in these diseases.
Collapse
Affiliation(s)
- Christophe Nicol
- Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest, Bretagne, France
| | - Karine Lacut
- Département de Médecine Interne et Pneumologie, CHRU de Brest, Bretagne, France.,GETBO, Groupe d'Etude de la Thrombose de Bretagne Occidentale, CHRU de Brest, Brest, Bretagne, France
| | - Brigitte Pan-Petesch
- Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest, Bretagne, France.,GETBO, Groupe d'Etude de la Thrombose de Bretagne Occidentale, CHRU de Brest, Brest, Bretagne, France
| | - Eric Lippert
- Laboratoire d'Hématologie, CHRU de Brest, Bretagne, France.,FIM, France Intergroupe des Néoplasies Myéloprolifératives, France
| | - Jean-Christophe Ianotto
- Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest, Bretagne, France.,GETBO, Groupe d'Etude de la Thrombose de Bretagne Occidentale, CHRU de Brest, Brest, Bretagne, France.,FIM, France Intergroupe des Néoplasies Myéloprolifératives, France
| |
Collapse
|
27
|
Tondeur S, Paul F, Riou J, Mansier O, Ranta D, Le Clech L, Lippert E, Tavitian S, Chaoui D, Mercier M, De Renzis B, Cottin L, Cassinat B, Chrétien JM, Ianotto JC, Allangba O, Marzac C, Voillat L, Boyer F, Orvain C, Hunault-Berger M, Girodon F, Kiladjian JJ, Ugo V, Luque Paz D. Long-term follow-up of JAK2 exon 12 polycythemia vera: a French Intergroup of Myeloproliferative Neoplasms (FIM) study. Leukemia 2020; 35:871-875. [PMID: 32694617 DOI: 10.1038/s41375-020-0991-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/09/2020] [Accepted: 07/14/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Sylvie Tondeur
- CHU Grenoble, Laboratoire de Génétique des hémopathies, Institut de Biologie et Pathologie, Grenoble, France.,CNRS UMR 5309, INSERM, U1209, Université Grenoble Alpes, Institute for Advanced Bioscience, Grenoble, France
| | - Franciane Paul
- CHU Montpellier, Service d'Hématologie clinique, Montpellier, France
| | - Jérémie Riou
- Université d'Angers, INSERM 1066 MINT, Angers, France
| | - Olivier Mansier
- CHU de Bordeaux, Laboratoire d'Hématologie et Université de Bordeaux, Inserm U1034, Bordeaux, France
| | - Dana Ranta
- CHU Nancy, Hématologie clinique, Nancy, France
| | | | - Eric Lippert
- CHRU Brest, Laboratoire d'Hématologie, Brest, France.,Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Brest, France.,Université Brest, Inserm, EFS, UMR 1078, GGB, Brest, France
| | - Suzanne Tavitian
- CHU Toulouse, Service d'Hématologie, Toulouse Oncopole, Toulouse, France
| | - Driss Chaoui
- CH Argenteuil, Service d'Hématologie, Argenteuil, France
| | | | - Benoit De Renzis
- CHU Clermont-Ferrand, Hématologie clinique, Clermont-Ferrand, France
| | - Laurane Cottin
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Brest, France.,CHU Angers, Laboratoire d'hématologie, Angers, France.,Université d'Angers, UFR Santé, Angers, France.,Université d'Angers, Inserm, CRCINA, F-49000, Angers, France
| | - Bruno Cassinat
- APHP, Hôpital Saint Louis, Laboratoire de Biologie Cellulaire, Paris, France
| | - Jean-Marie Chrétien
- CHU Angers, DRCI Cellule de Gestion des Données et Evaluation, Angers, France
| | - Jean-Christophe Ianotto
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Brest, France.,CHRU Brest, Service d'hématologie clinique, Brest, France
| | | | - Christophe Marzac
- Gustave Roussy, Département de Biologie et Pathologie médicales, Brest, France
| | | | - Françoise Boyer
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Brest, France.,CHU Angers, Service des maladies du sang, Angers, France
| | - Corentin Orvain
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Brest, France.,CHU Angers, Service des maladies du sang, Angers, France
| | - Mathilde Hunault-Berger
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Brest, France.,Université d'Angers, UFR Santé, Angers, France.,Université d'Angers, Inserm, CRCINA, F-49000, Angers, France.,CHU Angers, Service des maladies du sang, Angers, France
| | | | - Jean-Jacques Kiladjian
- APHP, Hôpital Saint Louis, INSERM UMRS 1131, Institut Universitaire d'Hématologie, Paris, France
| | - Valérie Ugo
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Brest, France.,CHU Angers, Laboratoire d'hématologie, Angers, France.,Université d'Angers, UFR Santé, Angers, France.,Université d'Angers, Inserm, CRCINA, F-49000, Angers, France
| | - Damien Luque Paz
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Brest, France. .,CHU Angers, Laboratoire d'hématologie, Angers, France. .,Université d'Angers, UFR Santé, Angers, France. .,Université d'Angers, Inserm, CRCINA, F-49000, Angers, France.
| |
Collapse
|
28
|
Mornet C, Galinat H, Mingant F, Ianotto JC, Lippert E. [Thrombosis and platelet dysfunction in myeloproliferative neoplasms]. Rev Med Interne 2020; 41:319-324. [PMID: 32008800 DOI: 10.1016/j.revmed.2019.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 12/23/2019] [Indexed: 12/15/2022]
Abstract
Myeloproliferative neoplasms are acquired hematological malignancies, mainly affecting the adult and whose morbidity and mortality stems from haemostasis disorders. The most frequently encountered complications include thrombosis, affecting preferentially the arterial territory, but also atypical locations such as splanchnic vein thrombosis. The pathophysiology of these thromboses is complex and involves different actors: blood cells, endothelium and flow conditions. Numerous studies have been conducted to identify risk factors for thrombosis. To date, only two risk factors have been validated through prospective studies (age over 60 years old, history of thrombotic events) and allow classification of patients as "low risk" and "high risk" as the basis for current treatment recommendations. Haemorrhagic manifestations, less frequent than thrombosis, are mainly related to an alteration of primary haemostasis and are therefore manifested by mucocutaneous bleeding. In these patients, platelet dysfunctions and/or acquired Willebrand syndromes can be found. The pathophysiology of thrombosis and platelet dysfunction during myeloproliferative neoplasms remains to date partially unknown. In this review, we offer to focus on physiopathological mechanisms as well as the latest advances in their understanding.
Collapse
Affiliation(s)
- C Mornet
- Hématologie biologique, CHU de Brest, Brest, France
| | - H Galinat
- Hématologie biologique, CHU de Brest, Brest, France
| | - F Mingant
- Hématologie biologique, CHU de Brest, Brest, France
| | - J C Ianotto
- Hématologie clinique et thérapie cellulaire, CHU de Brest, Brest, France
| | - E Lippert
- Hématologie biologique, CHU de Brest, Brest, France; Inserm, EFS, UMR 1078, GGB, Université Brest, Brest, France.
| |
Collapse
|
29
|
Le Clech L, Uguen M, Quinio D, Nevez G, Couturier MA, Ianotto JC, Berthou C, Guillerm G, Le Bars H, Payan C, Narbonne V, Baron R, Saliou P. Evaluation of posaconazole antifungal prophylaxis in reducing the incidence of invasive aspergillosis in patients with acute myeloid leukemia. Curr Res Transl Med 2019; 68:23-28. [PMID: 31787568 DOI: 10.1016/j.retram.2019.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 05/23/2019] [Revised: 10/28/2019] [Accepted: 11/11/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE OF THE STUDY Invasive aspergillosis (IA) is the most prevalent invasive fungal disease (IFD) in neutropenic patients. Environment is the main source of Aspergillus spores aerosolization especially during building construction. International guidelines recommend mechanical protection during hospital building works; otherwise the use of antifungal prophylaxis is not clearly indicated. Our objective was to determine the efficacy of antifungal prophylaxis by posaconazole on IA incidence in acute myeloid leukemia population and to analyse the benefit of this prophylaxis and HEPA-filters during hospital buildings works. PATIENTS AND METHODS We included patients treated for acute myeloid leukemia at Brest teaching hospital from January 2009 to December 2015. We compared incidence of IA in the group treated by posaconazole from 2012 to 2015 to the incidence of IA in the first group who did not receive antifungal prophylaxis (from 2009 to 2011). The one-year overall survival was also analyzed using the Kaplan-Meier method. RESULTS 245 patients were enrolled including 151 treated with posaconazole. 23 IA were diagnosed between 2009 and 2011 (without antifungal prophylaxis), then 31 between 2012 and 2015 (with posaconazole) without statistical difference between the incidence densities (0.34 per 100 hospitalization-days vs. 0.30 per 100 hospitalization-days, p = 0.71). Incidence density of IA increased during building works (2.40 per 100 hospitalization-days vs. 0.28 per 100 hospitalization-days, p < 0.0001). The incidence density of IA significantly decreased during construction periods when posaconazole prophylaxis was used (1.59 per 100 hospitalization-days vs. 4.87 per 100 hospitalization-days p < 0.0001). CONCLUSION Our study suggests, for the first time, the interest of antifungal prophylaxis in addition to HEPA filtration in prevention of IA during hospital building works.
Collapse
Affiliation(s)
- Lenaïg Le Clech
- Department of Haematology, Brest Teaching Hospital, Brest, France; Department of Internal Medicine, Infectious Diseases and Haematology, Cornouaille Hospital Quimper, Quimper, France
| | - Marie Uguen
- Infection Control Unit, Brest Teaching Hospital, Brest, France
| | - Dorothée Quinio
- Laboratory of Mycology, Brest Teaching Hospital, GEIHP EA 3142, Brest, France
| | - Gilles Nevez
- Laboratory of Mycology, Brest Teaching Hospital, GEIHP EA 3142, Brest, France; Université de Bretagne Occidentale, Brest, France
| | | | | | - Christian Berthou
- Department of Haematology, Brest Teaching Hospital, Brest, France; Université de Bretagne Occidentale, Brest, France
| | - Gaëlle Guillerm
- Department of Haematology, Brest Teaching Hospital, Brest, France
| | - Hervé Le Bars
- Department of Microbiology, Brest Teaching Hospital, Brest, France
| | - Christopher Payan
- Université de Bretagne Occidentale, Brest, France; Department of Microbiology, Brest Teaching Hospital, Brest, France; Inserm U1078, Génétique, Génomique et Biotechnologies, Brest, France
| | - Valérie Narbonne
- Department of Microbiology, Brest Teaching Hospital, Brest, France
| | - Raoul Baron
- Infection Control Unit, Brest Teaching Hospital, Brest, France
| | - Philippe Saliou
- Infection Control Unit, Brest Teaching Hospital, Brest, France; Université de Bretagne Occidentale, Brest, France; Inserm U1078, Génétique, Génomique et Biotechnologies, Brest, France.
| |
Collapse
|
30
|
Le Gall-Ianotto C, Le Calloch R, Couturier MA, Chauveau A, Lippert E, Carré JL, Misery L, Ianotto JC. Aquagenic pruritus in essential thrombocythemia is associated with a higher risk of thrombosis. J Thromb Haemost 2019; 17:1950-1955. [PMID: 31344312 DOI: 10.1111/jth.14588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 07/22/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Thromboses and phenotypic evolutions (leukemia, myelofibrosis) are the most frequent complications in polycythemia vera (PV) and essential thrombocythemia (ET). Aquagenic pruritus (AP) is not only PV symptom, but is also present in ET. The presence of pruritus in PV is associated with a lower risk of arterial thrombosis. AIMS To date, no equivalent study has been done to analyse the impact of AP for ET patients. MATERIALS & METHODS We used the data from our cohort of patients with myeloproliferative neoplasms seen in our institution (OBENE database, NCT02897297). We collect information at diagnosis, presence or not of AP and all types of complications during their follow-up. To avoid masked PV, all JAK2 positive cases were tested isotopic red mass cell if appropriate. RESULTS Among 396 ET patients, presence of AP was found in 42 (10.6%). ET patients with AP were more proliferative, more symptomatic at diagnosis and more difficult to treat. Furthermore, they presented increased risk of thromboses (30.9 versus 17%, P = .03; OR = 2.2 [1.01;4.66]) and phenotypic evolutions (33.3 versus 13.3%, P = .0007; OR = 3.2 [1.44;6.77]), during follow-up. DISCUSSION Aquagenic pruritus is classically associated to PV. But we confirmed here that AP is also present in ET and characterizes patients with higher risk of morbidity (thrombotic events and phenotypic evolutions). CONCLUSIONS The systematic determination of the presence of AP in ET patients should permit us to better identify these high-risk patients for better management and follow-up.
Collapse
Affiliation(s)
- Christelle Le Gall-Ianotto
- Department of Dermatology, University Hospital of Brest, Brest, France
- Laboratory of Interactions Neurons-Keratinocytes, University of Brest, Brest, France
| | - Ronan Le Calloch
- Department of Internal Medicine-Hematology, Hospital of Cornouaille, Quimper, France
| | | | - Aurélie Chauveau
- Laboratory of Hematology, University Hospital of Brest, Brest, France
- France Intergroup of Myeloproliferative Neoplasms (FIM), France
| | - Eric Lippert
- Laboratory of Hematology, University Hospital of Brest, Brest, France
- France Intergroup of Myeloproliferative Neoplasms (FIM), France
| | - Jean-Luc Carré
- Laboratory of Interactions Neurons-Keratinocytes, University of Brest, Brest, France
- Laboratory of Biochemistry, University Hospital of Brest, Brest, France
| | - Laurent Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
- Laboratory of Interactions Neurons-Keratinocytes, University of Brest, Brest, France
| | - Jean-Christophe Ianotto
- Department of Clinical Hematology, University Hospital of Brest, Brest, France
- France Intergroup of Myeloproliferative Neoplasms (FIM), France
| |
Collapse
|
31
|
Hoffmann C, Amiral J, Rezig S, Kerspern H, Jantzem H, Robin S, Collins A, Mornet C, Mingant F, Pan Petesch B, Ianotto JC, Lippert E, Galinat H. A very potent factor V inhibitor interferes with the levels of all coagulation factors and causes a fatal hemorrhagic syndrome. Eur J Haematol 2019; 103:137-139. [PMID: 31102471 DOI: 10.1111/ejh.13249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 12/01/2022]
Abstract
We report a very high factor V inhibitor affecting the measurement of all coagulation factors besides fibrinogen, all these factors being dramatically decreased. This inhibitor could be linked to antibiotic use. The patient died of massive hemorrhage before a plasma exchange could be initiated.
Collapse
Affiliation(s)
| | | | | | | | | | - Sara Robin
- CHRU Brest - Service de Médecine Interne, Brest, France
| | - Adam Collins
- CHRU Brest - Laboratoire d'Hématologie, Brest, France
| | - Clelia Mornet
- CHRU Brest - Laboratoire d'Hématologie, Brest, France
| | - Fanny Mingant
- CHRU Brest - Laboratoire d'Hématologie, Brest, France
| | | | | | - Eric Lippert
- CHRU Brest - Laboratoire d'Hématologie, Brest, France.,Univ Brest, Inserm, EFS, UMR 1078, GGB, Brest, France
| | | |
Collapse
|
32
|
Ianotto JC, Curto-Garcia N, Lauermanova M, Radia D, Kiladjian JJ, Harrison CN. Characteristics and outcomes of patients with essential thrombocythemia or polycythemia vera diagnosed before 20 years of age: a systematic review. Haematologica 2019; 104:1580-1588. [PMID: 30679326 PMCID: PMC6669170 DOI: 10.3324/haematol.2018.200832] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [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: 06/29/2018] [Accepted: 01/21/2019] [Indexed: 01/07/2023] Open
Abstract
Although it is well known that myeloproliferative neoplasms occur in younger patients, few large cohorts of such patients have been reported. Thus, our knowledge about circumstances of diagnosis, outcome and treatment is limited, especially for children and young adults. We therefore performed a systematic review of cases, published since 2005, concerning patients aged below 20 years at the time of diagnosis of essential thrombocythemia or polycythemia vera. We identified 396 cases of essential thrombocythemia and 75 of polycythemia vera. The median age at diagnosis was 9.3 and 12 years, respectively, and females constituted 57.6% and 45% of the groups, respectively. Half of the patients were asymptomatic at diagnosis. The proportion of so-called triple negativity was high: 57% in essential thrombocythemia and 73% in polycythemia vera. The incidence of thrombosis during the follow-up was 9.3% in patients with polycythemia vera and less, 3.8%, in those with essential thrombocythemia. Venous events were predominant (84.2%), with hemorrhagic episodes being rarer (<5%). The risk of evolution also seemed low (2% to myelofibrosis and no reports of acute leukemia), but the median follow-up was only 50 months. Survival curves were not available. Half of the patients received an antithrombotic drug and 40.5% received a cytoreductive drug. All data should be analyzed with care because of the proportion of missing data (10.7% to 74.7%). This review highlights interesting points concerning this population of young patients with myeloproliferative neoplasms, including that such patients were identified as negative for all common driver mutations, but also shows the need for larger contemporary cohorts with longer follow-up to assess the true prognosis of these patients.
Collapse
Affiliation(s)
- Jean-Christophe Ianotto
- Department of Haematology, Guy's and St Thomas' NHS Trust, London, UK.,Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, Centre Hospitalier Régional et Universitaire de Brest, Brest, France
| | | | - Marie Lauermanova
- Department of Haematology, Guy's and St Thomas' NHS Trust, London, UK.,Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Deepti Radia
- Department of Haematology, Guy's and St Thomas' NHS Trust, London, UK
| | | | - Claire N Harrison
- Department of Haematology, Guy's and St Thomas' NHS Trust, London, UK
| |
Collapse
|
33
|
Pigneux A, Béné MC, Salmi LR, Dumas PY, Delaunay J, Bonmati C, Guièze R, Luquet I, Cornillet-Lefebvre P, Delabesse E, Ianotto JC, Ojeda-Uribe M, Hunault M, Banos A, Fornecker LM, Bernard M, Jourdan E, Vey N, Zerazhi H, Hishri Y, Mineur A, Asselineau J, Delepine R, Cahn JY, Ifrah N, Récher C. Improved Survival by Adding Lomustine to Conventional Chemotherapy for Elderly Patients With AML Without Unfavorable Cytogenetics: Results of the LAM-SA 2007 FILO Trial. J Clin Oncol 2018; 36:3203-3210. [DOI: 10.1200/jco.2018.78.7366] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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
Purpose Acute myeloid leukemia (AML) in elderly patients has a poor prognosis. In an attempt to improve outcome for these patients, the prospective open-label phase III LAM-SA 2007 (Adding Lomustine to Chemotherapy in Older Patients With Acute Myelogenous Leukemia (AML), and Allogeneic Transplantation for Patients From 60 to 65 Years Old) trial randomly assigned patients to a standard induction regimen with lomustine added or to a consolidation regimen with cytarabine and idarubicin. Patients and Methods Adults age 60 years or older with previously untreated AML who were fit to receive intensive chemotherapy and who were without unfavorable cytogenetics received standard chemotherapy with lomustine (idarubicin, cytarabine, and lomustine [ICL]) or without (idarubicin and cytarabine [IC]). The primary objective of the study was overall survival (OS); secondary objectives were response rate, cumulative incidence of relapse (CIR), event-free survival (EFS), and safety. Results From February 2008 to December 2011, 459 patients were enrolled. Comparing patients in the IC and ICL arms, complete response or complete response with incomplete recovery was achieved in 74.9% versus 84.7% ( P = .01). The proportional hazards assumption was rejected for OS ( P = .02), which led us to consider two separate time intervals: during and after induction. There was no significant difference between the two arms during induction, although induction deaths were 3.7% versus 7.7%, respectively ( P = .11). However, significantly better results were observed after induction with an improved 2-year OS of 56% in the ICL arm versus 48% in the IC arm ( P = .02). At 2 years, EFS was improved at 41% in the ICL arm versus 26% in the IC arm ( P = .01). The CIR at 2 years was 41.2% in the ICL arm versus 60.9% in the IC arm ( P = .003). Grade 3 and 4 toxicities, mostly hematologic, were significantly higher in the ICL arm ( P = .04), and fewer patients required a second treatment after ICL. Conclusion Adding lomustine to standard chemotherapy significantly improved the outcome of elderly patients with AML.
Collapse
Affiliation(s)
- Arnaud Pigneux
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Marie C. Béné
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Louis-Rachid Salmi
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Pierre-Yves Dumas
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Jacques Delaunay
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Caroline Bonmati
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Romain Guièze
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Isabelle Luquet
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Pascale Cornillet-Lefebvre
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Eric Delabesse
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Jean-Christophe Ianotto
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Mario Ojeda-Uribe
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Mathilde Hunault
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Anne Banos
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Luc Matthieu Fornecker
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Marc Bernard
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Eric Jourdan
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Norbert Vey
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Hacene Zerazhi
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Yosr Hishri
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Ariane Mineur
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Julien Asselineau
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Roselyne Delepine
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Jean-Yves Cahn
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Norbert Ifrah
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | - Christian Récher
- Arnaud Pigneux and Pierre-Yves Dumas, Bordeaux University Hospital, Bordeaux University, INSERM 1035; Louis-Rachid Salmi, Ariane Mineur, and Julien Asselineau, Bordeaux University Hospital, Bordeaux; Marie C. Béné, and Jacques Delaunay, Nantes University Hospital, Nantes; Caroline Bonmati, Nancy University Hospital, Nancy; Romain Guièze, Clermont-Ferrand University Hospital, Clermont Ferrand; Isabelle Luquet, Eric Delabesse, and Christian Récher, Toulouse University Hospital, Toulouse; Pascale Cornillet
| | | |
Collapse
|
34
|
Affiliation(s)
| | - Jean-Christophe Ianotto
- Department of Haematology; Guy's and St Thomas' NHS Foundation Trust; London UK
- Institut de Cancéro-Hématologie; CHRU de Brest; Brest France
| | - Claire N. Harrison
- Department of Haematology; Guy's and St Thomas' NHS Foundation Trust; London UK
| |
Collapse
|
35
|
Mansier O, Luque Paz D, Ianotto JC, Le Bris Y, Chauveau A, Boyer F, Conejero C, Fitoussi O, Riou J, Adiko D, Touati M, Chauzeix J, Viallard JF, Béné MC, Giraudier S, Ugo V, Lippert E. Clinical and biological characterization of MPN patients harboring two driver mutations, a French intergroup of myeloproliferative neoplasms (FIM) study. Am J Hematol 2018; 93:E84-E86. [PMID: 29266414 DOI: 10.1002/ajh.25014] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 12/16/2017] [Accepted: 12/18/2017] [Indexed: 01/23/2023]
Affiliation(s)
- Olivier Mansier
- UFR Sciences de la Vie et de la Santé; Université de Bordeaux; Bordeaux France
- CHU de Bordeaux, Laboratoire d'Hématologie; Bordeaux France
- INSERM U1218, ACTION, Université de Bordeaux; Bordeaux France
| | - Damien Luque Paz
- Université Angers, UFR Santé; Angers France
- CHU d'Angers, Laboratoire d'Hématologie; Angers France
- CRCINA, INSERM, Université d'Angers; Angers France
- Fédération Hospitalo-Universitaire ‘Grand Ouest Against Leukemia’ (FHU GOAL); Angers France
| | - Jean-Christophe Ianotto
- Fédération Hospitalo-Universitaire ‘Grand Ouest Against Leukemia’ (FHU GOAL); Angers France
- CHU de Brest, Service d'Hématologie Clinique; Brest France
| | - Yannick Le Bris
- Fédération Hospitalo-Universitaire ‘Grand Ouest Against Leukemia’ (FHU GOAL); Angers France
- CHU de Nantes, Laboratoire d'Hématologie; Nantes France
| | - Aurélie Chauveau
- Fédération Hospitalo-Universitaire ‘Grand Ouest Against Leukemia’ (FHU GOAL); Angers France
- CHU de Brest, Laboratoire d'Hématologie; Brest France
- INSERM U1078, CHRU Brest; Brest France
- Université de Bretagne Occidentale, UFR Médecine; Brest France
| | - Françoise Boyer
- Fédération Hospitalo-Universitaire ‘Grand Ouest Against Leukemia’ (FHU GOAL); Angers France
- CHU d'Angers, Service des Maladies du Sang; Angers France
| | - Carole Conejero
- AP-HP, CHU Henri Mondor, Laboratoire d'Hématologie; Créteil France
| | - Olivier Fitoussi
- Polyclinique Bordeaux Nord Aquitaine, Service d'hémato-oncologie; Bordeaux France
| | - Jérémie Riou
- INSERM 1066 MINT, Université d'Angers; Angers France
| | - Didier Adiko
- Service de Médecine-Hématologie; CH Robert Boulin; Libourne France
| | | | - Jasmine Chauzeix
- CHU de Limoges, Laboratoire d'Hématologie, CRBS; Limoges France
- UMR CNRS 7276; Limoges France
| | | | - Marie C. Béné
- Fédération Hospitalo-Universitaire ‘Grand Ouest Against Leukemia’ (FHU GOAL); Angers France
- CHU de Nantes, Laboratoire d'Hématologie; Nantes France
| | | | - Valérie Ugo
- Université Angers, UFR Santé; Angers France
- CHU d'Angers, Laboratoire d'Hématologie; Angers France
- CRCINA, INSERM, Université d'Angers; Angers France
- Fédération Hospitalo-Universitaire ‘Grand Ouest Against Leukemia’ (FHU GOAL); Angers France
| | - Eric Lippert
- Fédération Hospitalo-Universitaire ‘Grand Ouest Against Leukemia’ (FHU GOAL); Angers France
- CHU de Brest, Laboratoire d'Hématologie; Brest France
- INSERM U1078, CHRU Brest; Brest France
- Université de Bretagne Occidentale, UFR Médecine; Brest France
| |
Collapse
|
36
|
Delluc A, Lacut K, Pan-Petesch B, Galinat H, Lippert E, Ianotto JC. Statin exposure and thrombosis risk in patients with myeloproliferative neoplasms. Thromb Res 2018; 167:57-59. [PMID: 29787944 DOI: 10.1016/j.thromres.2018.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/11/2018] [Accepted: 05/13/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Aurélien Delluc
- EA 3878 (GETBO), Brest University, 29200 Brest, France; Department of Chest Diseases and Internal Medicine, Hôpital de la Cavale Blanche, 29609 Brest Cedex, France.
| | - Karine Lacut
- EA 3878 (GETBO), Brest University, 29200 Brest, France; INSERM CIC 1412, Hôpital de la Cavale Blanche, 29609 Brest Cedex, France
| | - Brigitte Pan-Petesch
- EA 3878 (GETBO), Brest University, 29200 Brest, France; Oncology and Hematology Institute, Hôpital Morvan, 29609 Brest Cedex, France
| | - Hubert Galinat
- EA 3878 (GETBO), Brest University, 29200 Brest, France; Oncology and Hematology Institute, Hôpital Morvan, 29609 Brest Cedex, France
| | - Eric Lippert
- Laboratoire d'Hématologie, Equipe ECLA, UMR1078 "Génétique, Génomique Fonctionnelle et Biotechnologies", Brest University, IBSAM, 29200 Brest, France
| | - Jean-Christophe Ianotto
- EA 3878 (GETBO), Brest University, 29200 Brest, France; Oncology and Hematology Institute, Hôpital Morvan, 29609 Brest Cedex, France
| |
Collapse
|
37
|
Mollard LM, Chauveau A, Boyer-Perrard F, Douet-Guilbert N, Houot R, Quintin-Roué I, Couturier MA, Dagorne A, Malou M, Le Calloch R, Luycx O, Thepot S, Hunault M, Guillerm G, Berthou C, Ugo V, Lippert É, Ianotto JC. Outcome of Ph negative myeloproliferative neoplasms transforming to accelerated or leukemic phase. Leuk Lymphoma 2018; 59:2812-2820. [PMID: 29616837 DOI: 10.1080/10428194.2018.1441408] [Citation(s) in RCA: 11] [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] [Indexed: 01/05/2023]
Abstract
Myeloproliferative neoplasms (MPN) are chronic disorders that can sometimes evolve into accelerated or leukemic phases. We retrospectively identified 122 patients with such blastic phases. The overall median survival was four months: 10.2 months for patients treated with intensive treatments compared to three months for best supportive care (p = .005). Azacytidine, intensive chemotherapies, or allogeneic stem cell transplantation gave the highest median survivals with 9, 10.2, and 19.4 months, respectively. Accelerated phases (AP) had a longer median survival compared to acute leukemia (4.8 months vs. 3.1 months; p = .02). In this retrospective and observational study, we observe that the longest survivals are seen in patients eligible for intensive treatments. Azacytidine shows interesting results in patients non-fit for intensive chemotherapy. Supportive care should probably be restricted to elderly patients and those with unfavorable karyotype. An early diagnosis of AP could also result in a better survival rate.
Collapse
Affiliation(s)
- Lise-Marie Mollard
- a Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest , Brest , France
| | | | | | | | - Roch Houot
- e Laboratoire d'Anatomo-Pathologie, CHRU Brest , Brest , France
| | | | | | - Anaig Dagorne
- h Service d'Hématologie Clinique, CH de Morlaix , Brest , France
| | - Mohamed Malou
- i Service de Médecine Interne, CH de Quimper , Brest , France
| | | | - Odile Luycx
- k Laboratoire d'Hématologie, CHU d'Angers , Brest , France
| | - Sylvain Thepot
- c Service des Maladies du Sang, CHU d'Angers , Brest , France
| | | | - Gaelle Guillerm
- a Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest , Brest , France
| | - Christian Berthou
- a Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest , Brest , France
| | - Valérie Ugo
- i Service de Médecine Interne, CH de Quimper , Brest , France
| | - Éric Lippert
- b Laboratoire d'Hématologie, CHRU de Brest , Brest , France
| | - Jean-Christophe Ianotto
- a Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest , Brest , France
| |
Collapse
|
38
|
Le Clech L, Talarmin JP, Couturier MA, Ianotto JC, Nicol C, Le Calloch R, Dos Santos S, Hutin P, Tandé D, Cogulet V, Berthou C, Guillerm G. Early discontinuation of empirical antibacterial therapy in febrile neutropenia: the ANTIBIOSTOP study. Infect Dis (Lond) 2018; 50:539-549. [PMID: 29451055 DOI: 10.1080/23744235.2018.1438649] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [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] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Immediate empirical antibiotic therapy is mandatory in febrile chemotherapy-induced neutropenia, but its optimal duration is unclear, especially in patients with fever of unknown origin (FUO). OBJECTIVES The primary objective of this 20-month prospective observational study was to evaluate the feasibility and safety of short-term antibiotic treatment in afebrile or febrile patients exhibiting FUO, irrespective of their neutrophil count. The secondary objective was to describe the epidemiology of all episodes of febrile neutropenia. METHODS In the first phase of the study, empirical antibiotic therapy in FUO patients was stopped after 48 h of apyrexia, in accordance with European Conference on Infections in Leukaemia guidelines (n = 45). In the second phase of the study, antibiotics were stopped no later than day 5 for all FUO patients, regardless of body temperature or leukocyte count (n = 37). RESULTS Two hundred and thirty-eight cases of febrile neutropenia in 123 patients were included. Neither the composite endpoint (p = .11), nor each component (in-hospital mortality (p = .80), intensive care unit admission (p = 0.48), relapse of infection ≤48 h after discontinuation of antibiotics (p = .82)) differed between the two FUO groups. Violation of protocol occurred in 17/82 episodes of FUO without any major impact on statistical results. Twenty-six (57.3%) and 22 (59.5%) FUO episodes did not relapse during hospital-stay (p = 1), and nine (20%) and five (13.5%) presented another FUO, respectively. One hundred and fifty-six episodes of febrile neutropenia (65.5%) were clinically or microbiologically documented, including 85 bacteremia. CONCLUSIONS These results suggest that early discontinuation of empirical antibiotics in FUO is safe for afebrile neutropenic patients.
Collapse
Affiliation(s)
- Lenaïg Le Clech
- a Department of Haematology , Brest Teaching Hospital , Brest , France.,b Department of Internal Medicine, Infectious Diseases and Haematology , Cornouaille Hospital Quimper , Quimper , France
| | - Jean-Philippe Talarmin
- b Department of Internal Medicine, Infectious Diseases and Haematology , Cornouaille Hospital Quimper , Quimper , France
| | | | | | - Christophe Nicol
- a Department of Haematology , Brest Teaching Hospital , Brest , France
| | - Ronan Le Calloch
- a Department of Haematology , Brest Teaching Hospital , Brest , France
| | | | - Pascal Hutin
- b Department of Internal Medicine, Infectious Diseases and Haematology , Cornouaille Hospital Quimper , Quimper , France
| | - Didier Tandé
- c Laboratory of Bacteriology , Brest Teaching Hospital , Brest , France
| | - Virginie Cogulet
- d Department of Pharmacy , Brest Teaching Hospital , Brest , France
| | - Christian Berthou
- a Department of Haematology , Brest Teaching Hospital , Brest , France
| | - Gaëlle Guillerm
- a Department of Haematology , Brest Teaching Hospital , Brest , France
| |
Collapse
|
39
|
Le Calloch R, Lacut K, Le Gall-Ianotto C, Nowak E, Abiven M, Tempescul A, Dalbies F, Eveillard JR, Ugo V, Giraudier S, Guillerm G, Lippert E, Berthou C, Ianotto JC. Non-adherence to treatment with cytoreductive and/or antithrombotic drugs is frequent and associated with an increased risk of complications in patients with polycythemia vera or essential thrombocythemia (OUEST study). Haematologica 2017; 103:607-613. [PMID: 29246923 PMCID: PMC5865440 DOI: 10.3324/haematol.2017.180448] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 09/11/2017] [Accepted: 12/15/2017] [Indexed: 01/28/2023] Open
Abstract
The purpose of this study was to identify the incidence, causes and impact of non-adherence to oral and subcutaneous chronic treatments for patients with polycythemia vera or essential thrombocythemia. Patients receiving cytoreductive drugs for polycythemia vera or essential thrombocythemia were recruited at our institution (Observatoire Brestois des Néoplasies Myéloprolifératives registry). They completed a one-shot questionnaire designed by investigators (Etude de l’Observance Thérapeutique et des Effets Secondaires des Traitements study). Data about complications (thrombosis, transformation and death) at any time in the patient’s life (before diagnosis, up until consultation and after the completion of the questionnaire) were collected. Sixty-five (22.7%) of 286 patients reported poor adherence (<90%) to their treatment with cytoreductive drugs and 46/255/18%) also declared non-adherence to antithrombotic drugs. In total, 85/286 patients (29.7%) declared they did not adhere to their treatment. Missing an intake was rare and was mostly due to forgetfulness especially during occupational travel and holidays. Patients who did not adhere to their treatment were characterized by younger age, living alone, having few medications but a high numbers of pills and determining their own schedule of drug intake. Having experienced thrombosis or hematologic evolution did not influence the adherence rate. Non-adherence to oral therapy was associated with a higher risk of phenotypic evolution (7.3 versus 1.8%, P=0.05). For patients treated for polycythemia vera or essential thrombocythemia, non-adherence to cytoreductive and/or antithrombotic therapies is frequent and is influenced by age, habitus and concomitant treatments, but not by disease history or treatment side effects. Phenotypic evolution seems to be more frequent in the non-adherent group.
Collapse
Affiliation(s)
- Ronan Le Calloch
- Service de Médecine Interne-Maladies du Sang-Maladies Infectieuses (MIIS), CHIC de Quimper, France.,Fédération Inter Hospitalière d'Immuno-Hématologie de Bretagne Occidentale (FIHBO), France
| | - Karine Lacut
- CIC 1412, INSERM, Brest, France.,EA3878 G.E.T.B.O, Université de Bretagne Occidentale, Brest, France.,Département de Médecine Interne et Pneumologie, CHRU de Brest, France
| | | | | | | | - Adrian Tempescul
- Fédération Inter Hospitalière d'Immuno-Hématologie de Bretagne Occidentale (FIHBO), France.,Service d'Hématologie Clinique, Institut de Cancérologie et Hématologie, CHRU de Brest, France
| | - Florence Dalbies
- Fédération Inter Hospitalière d'Immuno-Hématologie de Bretagne Occidentale (FIHBO), France.,Service d'Hématologie Clinique, Institut de Cancérologie et Hématologie, CHRU de Brest, France
| | - Jean-Richard Eveillard
- Fédération Inter Hospitalière d'Immuno-Hématologie de Bretagne Occidentale (FIHBO), France.,Service d'Hématologie Clinique, Institut de Cancérologie et Hématologie, CHRU de Brest, France
| | - Valérie Ugo
- Laboratoire d'Hématologie, CHU d'Angers, France
| | | | - Gaëlle Guillerm
- Fédération Inter Hospitalière d'Immuno-Hématologie de Bretagne Occidentale (FIHBO), France.,Service d'Hématologie Clinique, Institut de Cancérologie et Hématologie, CHRU de Brest, France
| | - Eric Lippert
- Laboratoire d'Hématologie, CHRU de Brest and Equipe ECLA, INSERM U1078, Université de Bretagne Occidentale, Brest, France
| | - Christian Berthou
- Fédération Inter Hospitalière d'Immuno-Hématologie de Bretagne Occidentale (FIHBO), France.,Service d'Hématologie Clinique, Institut de Cancérologie et Hématologie, CHRU de Brest, France
| | - Jean-Christophe Ianotto
- Fédération Inter Hospitalière d'Immuno-Hématologie de Bretagne Occidentale (FIHBO), France .,EA3878 G.E.T.B.O, Université de Bretagne Occidentale, Brest, France.,Service d'Hématologie Clinique, Institut de Cancérologie et Hématologie, CHRU de Brest, France
| |
Collapse
|
40
|
Ianotto JC, Chauveau A, Boyer-Perrard F, Gyan E, Laribi K, Cony-Makhoul P, Demory JL, de Renzis B, Dosquet C, Rey J, Roy L, Dupriez B, Knoops L, Legros L, Malou M, Hutin P, Ranta D, Benbrahim O, Ugo V, Lippert E, Kiladjian JJ. Benefits and pitfalls of pegylated interferon-α2a therapy in patients with myeloproliferative neoplasm-associated myelofibrosis: a French Intergroup of Myeloproliferative neoplasms (FIM) study. Haematologica 2017; 103:438-446. [PMID: 29217781 PMCID: PMC5830374 DOI: 10.3324/haematol.2017.181297] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [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: 09/22/2017] [Accepted: 12/06/2017] [Indexed: 12/12/2022] Open
Abstract
We have previously described the safety and efficacy of pegylated interferon-α2a therapy in a cohort of 62 patients with myeloproliferative neoplasm-associated myelofibrosis followed in centers affiliated to the French Intergroup of Myeloproliferative neoplasms. In this study, we report their long-term outcomes and correlations with mutational patterns of driver and non-driver mutations analyzed by targeted next generation sequencing. The median age at diagnosis was 66 years old, the median follow-up since starting pegylated interferon was 58 months. At the time of analysis, 30 (48.4%) patients were alive including 16 still being treated with pegylated interferon. The median survival of patients with intermediate and high-risk prognostic Lille and dynamic International Prognostic Scoring System scores treated with pegylated interferon was increased in comparison to that of historical cohorts. In addition, overall survival was significantly correlated with the duration of pegylated interferon therapy (70 versus 30 months after 2 years of treatment, P<10−12). JAK2V617F allele burden was decreased by more than 50% in 58.8% of patients and two patients even achieved complete molecular response. Next-generation sequencing analyses performed in 49 patients showed that 28 (57.1%) of them carried non-driver mutations. The presence of at least one additional mutation was associated with a reduction of both overall and leukemia-free survival. These findings in a large series of patients with myelofibrosis suggest that pegylated interferon therapy may provide a survival benefit for patients with intermediate- or high-risk Lille and dynamic International Prognostic Scoring System scores. It also reduced the JAK2V617F allele burden in most patients. These results further support the use of pegylated interferon in selected patients with myelofibrosis.
Collapse
Affiliation(s)
| | - Aurélie Chauveau
- Laboratoire d'Hématologie, CHRU de Brest and INSERM U1078, Université de Bretagne Occidentale, Brest, France
| | | | - Emmanuel Gyan
- Hématologie et Thérapie Cellulaire, CRU de Cancérologie H.S. Kaplan, Tours, France
| | | | | | - Jean-Loup Demory
- Service d'Hématologie, Hôpital St Vincent de Paul, Lille, France
| | | | | | - Jerome Rey
- Département d'Hématologie, Institut Paoli-Calmette, Marseille, France
| | - Lydia Roy
- Service d'Hématologie, Hôpital de Créteil, France
| | | | - Laurent Knoops
- Cliniques Universitaires Saint-Luc and Université Catholique de Louvain, Brussels, Belgium
| | | | - Mohamed Malou
- Service d'Oncologie et D'Hématologie, Hôpital de Morlaix, France
| | - Pascal Hutin
- Service de Médecine Interne et de Maladies Infectieuses, Hôpital Laennec, Quimper, France
| | - Dana Ranta
- Département d'Hématologie, Hôpital Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Omar Benbrahim
- Service d'Hématologie, Hôpital La Source, Orléans, France
| | - Valérie Ugo
- Laboratoire d'Hématologie, CHU d'Angers, France
| | - Eric Lippert
- Laboratoire d'Hématologie, CHRU de Brest and INSERM U1078, Université de Bretagne Occidentale, Brest, France
| | - Jean-Jacques Kiladjian
- Centre d'Investigation Clinique, Hôpital Saint-Louis, APHP, Université Paris Diderot, Inserm, Paris, France
| |
Collapse
|
41
|
Paz DL, Delluc A, Tromeur C, Couturier MA, Gouillou M, Berthou C, Mottier D, Ugo V, Ianotto JC, Chauveau A. Absence of CALR mutation among a cohort of 394 unselected patients with a first episode of unprovoked venous thromboembolism. Thromb Haemost 2017; 115:225-6. [DOI: 10.1160/th15-02-0134] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 06/23/2015] [Indexed: 11/05/2022]
|
42
|
Perrier-Cornet A, Ianotto JC, Mingant F, Perrot M, Lippert E, Galinat H. Decreased turnover aspirin resistance by bidaily aspirin intake and efficient cytoreduction in myeloproliferative neoplasms. Platelets 2017; 29:723-728. [DOI: 10.1080/09537104.2017.1361018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | | | - Fanny Mingant
- Service d’Hématologie Biologique, CHU de Brest, Brest, France
| | - Maëla Perrot
- Service d’Hématologie Biologique, CHU de Brest, Brest, France
| | - Eric Lippert
- Service d’Hématologie Biologique, CHU de Brest, Brest, France
| | - Hubert Galinat
- Service d’Hématologie Biologique, CHU de Brest, Brest, France
| |
Collapse
|
43
|
Scotch AH, Kosiorek H, Scherber R, Dueck AC, Slot S, Zweegman S, Boekhorst PAWT, Commandeur S, Schouten H, Sackmann F, Fuentes AK, Hernández-Maraver D, Pahl HL, Griesshammer M, Stegelmann F, Döhner K, Lehmann T, Bonatz K, Reiter A, Boyer F, Etienne G, Ianotto JC, Ranta D, Roy L, Cahn JY, Harrison CN, Radia D, Muxi P, Maldonado N, Besses C, Cervantes F, Johansson PL, Barbui T, Barosi G, Vannucchi AM, Paoli C, Passamonti F, Andreasson B, Ferrari ML, Rambaldi A, Samuelsson J, Birgegard G, Xiao Z, Xu Z, Zhang Y, Sun X, Xu J, Kiladjian JJ, Zhang P, Gale RP, Mesa RA, Geyer HL. Symptom burden profile in myelofibrosis patients with thrombocytopenia: Lessons and unmet needs. Leuk Res 2017; 63:34-40. [PMID: 29096334 DOI: 10.1016/j.leukres.2017.10.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 07/08/2017] [Revised: 10/07/2017] [Accepted: 10/11/2017] [Indexed: 12/19/2022]
Abstract
Myelofibrosis is a myeloproliferative neoplasm associated with progressive cytopenias and high symptom burden. MF patients with thrombocytopenia have poor prognosis but the presence of thrombocytopenia frequently precludes the use of JAK2 inhibitors. In this study, we assessed quality of life and symptom burden in 418 MF patients with (n=89) and without (n=329) thrombocytopenia using prospective data from the MPN-QOL study group database, including the Myeloproliferative Neoplasm Symptom Assessment Form (MPN-SAF) and Total Symptom Score (MPN10). Thrombocytopenia, defined as platelet count <100×109/L (moderate 51-100×109/L; severe ≤50×109/L), was associated with anemia (76% vs. 45%, p<0.001), leukopenia (29% vs. 11%, p<0.001), and need for red blood cell transfusion (35% vs. 19%, p=0.002). Thrombocytopenic patients had more fatigue, early satiety, inactivity, dizziness, sad mood, cough, night sweats, itching, fever, and weight loss; total symptom scores were also higher (33 vs. 24, p<0.001). Patients with severe thrombocytopenia were more likely to have anemia (86% vs. 67%, p=0.04), leukopenia (40% vs. 20%, p=0.04), and transfusion requirements (51% vs. 20%, p=0.002) but few differences in symptoms when compared to patients with moderate thrombocytopenia. These results suggest that MF patients with thrombocytopenia experience greater symptomatic burden than MF patients without thrombocytopenia and may benefit from additional therapies.
Collapse
Affiliation(s)
- Allison H Scotch
- Department of Internal Medicine, Mayo Clinic, Scottsdale, AZ USA.
| | - Heidi Kosiorek
- Section of Biostatistics, Mayo Clinic, Scottsdale, AZ USA
| | | | - Amylou C Dueck
- Section of Biostatistics, Mayo Clinic, Scottsdale, AZ USA
| | - Stefanie Slot
- Department of Hematology, VU University Medical Center, Amsterdam, Netherlands
| | - Sonja Zweegman
- Department of Hematology, VU University Medical Center, Amsterdam, Netherlands
| | | | | | | | | | | | | | - Heike L Pahl
- Department of Molecular Hematology, University Hospital Freiburg, Freiburg, Germany
| | | | - Frank Stegelmann
- Department of Internal Medicine III, University Hospital of Ulm, Germany
| | - Konstanze Döhner
- Department of Internal Medicine III, University Hospital of Ulm, Germany
| | - Thomas Lehmann
- Hematology Department, University Hospital Basel, Switzerland
| | - Karin Bonatz
- Medizinische Klinik, Universitätsmedizin Mannheim, Germany
| | - Andreas Reiter
- Medizinische Klinik, Universitätsmedizin Mannheim, Germany
| | | | | | | | - Dana Ranta
- Hospitalier Universitaire, Nancy, France
| | - Lydia Roy
- Centre Hospitalier Universitaire, Poitiers, France
| | | | - Claire N Harrison
- Dept of Haematology, Guy's and St. Thomas NHS Foundation Trust, London, United Kingdom
| | - Deepti Radia
- Dept of Haematology, Guy's and St. Thomas NHS Foundation Trust, London, United Kingdom
| | - Pablo Muxi
- Unidadde Hematología, Hospital Británico, Montevideo, Uruguay
| | - Norman Maldonado
- University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Carlos Besses
- Hematology Department, Hospital del Mar, Barcelona, Spain
| | - Francisco Cervantes
- Hematology Department, Hospital Clínic, IDIBAPS, University of Barcelona, Spain
| | | | - Tiziano Barbui
- Unit of Hematology, Ospedali Riuniti di Bergamo, Bergamo, Italy
| | - Giovanni Barosi
- Lab of Clinical Epidemiology, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
| | | | - Chiara Paoli
- Hematology, Dept of Medical and Surgical Care, University of Florence, Florence, Italy
| | - Francesco Passamonti
- Department of Hematology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | | | | | | | - Jan Samuelsson
- Department of Internal Medicine, Stockholm South Hospital, Stockholm, Sweden
| | | | - Zhijian Xiao
- MDS and MPN Centre, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Zefeng Xu
- MDS and MPN Centre, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Yue Zhang
- MDS and MPN Centre, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Xiujuan Sun
- MDS and MPN Centre, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Junqing Xu
- MDS and MPN Centre, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | | | - Peihong Zhang
- Department of Pathology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | | | - Ruben A Mesa
- Department of Hematology and Oncology, Mayo Clinic, Scottsdale, AZ USA
| | - Holly L Geyer
- Department of Internal Medicine, Mayo Clinic, Scottsdale, AZ USA.
| |
Collapse
|
44
|
Legros L, Nicolini FE, Etienne G, Rousselot P, Rea D, Giraudier S, Guerci-Bresler A, Huguet F, Gardembas M, Escoffre M, Ianotto JC, Noël MP, Varet BR, Pagliardini T, Touitou I, Morisset S, Mahon FX. Second tyrosine kinase inhibitor discontinuation attempt in patients with chronic myeloid leukemia. Cancer 2017; 123:4403-4410. [PMID: 28743166 DOI: 10.1002/cncr.30885] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [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: 04/10/2017] [Revised: 05/18/2017] [Accepted: 05/25/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Several studies have demonstrated that approximately one-half of patients with chronic myeloid leukemia (CML) who receive treatment with tyrosine kinase inhibitors (TKIs) and achieve and maintain a deep molecular response (DMR) are able to successfully discontinue therapy. In patients who have a molecular relapse, a DMR is rapidly regained upon treatment re-initiation. METHODS The authors report the results from RE-STIM, a French observational, multicenter study that evaluated treatment-free remission (TFR) in 70 patients who re-attempted TKI discontinuation after a first unsuccessful attempt. After the second TKI discontinuation attempt, the trigger for treatment re-introduction was the loss of a major molecular response in all patients. RESULTS The median follow-up was 38.3 months (range, 4.7-117 months), and 45 patients (64.3%) lost a major molecular response after a median time off therapy of 5.3 months (range, 2-42 months). TFR rates at 12, 24, and 36 months were 48% (95% confidence interval [CI], 37.6%-61.5%), 42% (95% CI, 31.5%-55.4%), and 35% (95% CI, 24.4%-49.4%), respectively. No progression toward advanced-phase CML occurred, and no efficacy issue was observed upon TKI re-introduction. In univariate analysis, the speed of molecular relapse after the first TKI discontinuation attempt was the only factor significantly associated with outcome. The TFR rate at 24 months was 72% (95% CI, 48.8%-100%) in patients who remained in DMR within the first 3 months after the first TKI discontinuation and 36% (95% CI, 25.8%-51.3%) for others. CONCLUSIONS This study is the first to demonstrate that a second TKI discontinuation attempt is safe and that a first failed attempt at discontinuing TKI does not preclude a second successful attempt. Cancer 2017;123:4403-10. © 2017 American Cancer Society.
Collapse
Affiliation(s)
- Laurence Legros
- Hematology Department, Nice University Hospital, Nice, France.,Valrose Institute of Biology, National Center for Scientific Research (CNRS) Unit 7277, National Institute of Health and Medical Research (INSERM) Unit 1091, Nice, France
| | - Franck E Nicolini
- Hematology Department, Lyon University Hospital, Pierre Benite, France.,INSERM Unit 1052, Leon Berard Center, Lyon, France
| | - Gabriel Etienne
- Haematology Department, Bergonie Institute, Bordeaux, France
| | - Philippe Rousselot
- Haematology and Oncology Department, Hopital A Mignot, INSERM Unit 1173, Versailles, University of Versailles St.-Quentin-Yvelines, France
| | - Delphine Rea
- Adult Hematology Department, INSERM Unit 1160, St. Louis Hospital, Paris, France
| | | | - Agnès Guerci-Bresler
- Hematology Department, Brabois University Hospital, Vandoeuvre-les-Nancy, France
| | - Françoise Huguet
- Hematology Department, Toulouse-Oncopole University Cancer Institute, Toulouse, France
| | - Martine Gardembas
- Blood Disorder Department, Angers University Hospital, Angers, France
| | - Martine Escoffre
- Adult Hematology Department, Rennes University Hospital, Rennes, France
| | | | - Marie-Pierre Noël
- Blood Disorders Department, Lille University Hospital, Lille, France
| | - Bruno R Varet
- Blood Disorders Department, Necker Hospital, Paris-Descartes University, Paris, France
| | | | - Irit Touitou
- Hematology Department, Nice University Hospital, Nice, France
| | - Stéphane Morisset
- Hematology Department, Lyon University Hospital, Pierre Benite, France
| | - Francois-Xavier Mahon
- Laboratory of Mammary and Leukemic Oncogenesis, Genetic Diversity, and Resistance to Treatment, INSERM Unit 1218, Bordeaux, France
| | | |
Collapse
|
45
|
Ianotto JC, Couturier MA, Galinat H, Mottier D, Berthou C, Guillerm G, Lippert E, Delluc A. Administration of direct oral anticoagulants in patients with myeloproliferative neoplasms. Int J Hematol 2017. [PMID: 28623609 DOI: 10.1007/s12185-017-2282-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [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] [Indexed: 12/19/2022]
Abstract
Direct oral anticoagulants (DOACs) have been approved to treat and prevent thrombotic events. However, they are not yet labeled for use in patients with active cancers. Myeloproliferative neoplasms (MPNs) are clonal chronic disorders with a high incidence of thrombotic events, for which low-dose aspirin (LDA) is the standard drug treatment. We analyzed efficacy and safety of DOACs prescription in patients treated for MPNs. An MPN database, the OBENE registry, was established at our institution. We collected biological and clinical data from diagnosis to last follow-up for every patient included in this study. Thrombotic and hemorrhagic events and hematologic evolutions were categorized as major events in the database. Of the 760 MPN patients in the OBENE registry, 25 (3.3%) were treated with a DOAC. Median follow-up duration was 2.1 years (0.12-4.3 years). The reasons for prescribing DOACs were atrial fibrillation and thrombotic events for 13 and 12 patients, respectively. We only observed one thrombotic event (4%) and three major hemorrhagic events (12%). A case-control study did not detect a significant difference in thrombotic or hemorrhagic events in patients treated with LDA and DOACs. These preliminary results suggest that DOACs may be highly efficient and safe for use in MPN patients.
Collapse
Affiliation(s)
- Jean-Christophe Ianotto
- Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest, Brest, France.
- INSERM EA-3878, GETBO (Groupe d'étude de la thrombose en Bretagne occidentale), CHRU de Brest, Brest, France.
| | - Marie-Anne Couturier
- Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest, Brest, France
| | | | - Dominique Mottier
- INSERM EA-3878, GETBO (Groupe d'étude de la thrombose en Bretagne occidentale), CHRU de Brest, Brest, France
- Département de Médecine Interne et de Pneumologie, CHRU de Brest, Brest, France
| | - Christian Berthou
- Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest, Brest, France
| | - Gaëlle Guillerm
- Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest, Brest, France
| | - Eric Lippert
- Laboratoire d'Hématologie, CHRU de Brest, Brest, France
| | - Aurélien Delluc
- INSERM EA-3878, GETBO (Groupe d'étude de la thrombose en Bretagne occidentale), CHRU de Brest, Brest, France
- Département de Médecine Interne et de Pneumologie, CHRU de Brest, Brest, France
| |
Collapse
|
46
|
Rousselot P, Rea D, Hacini M, Ianotto JC, Borie O, Cony Makhoul P, Etienne G. Étude BosEval : évaluation de l’efficacité, de la tolérance, ainsi que des modalités d’utilisation de Bosulif ® chez des patients atteints de leucémies myéloïes chroniques (LMC) Ph+ en phase chronique, avancée ou crise blastique en condition de vie réelle. Rev Epidemiol Sante Publique 2017. [DOI: 10.1016/j.respe.2017.04.053] [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: 11/29/2022] Open
|
47
|
Rea D, Henry G, Khaznadar Z, Etienne G, Guilhot F, Nicolini F, Guilhot J, Rousselot P, Huguet F, Legros L, Gardembas M, Dubruille V, Guerci-Bresler A, Charbonnier A, Maloisel F, Ianotto JC, Villemagne B, Mahon FX, Moins-Teisserenc H, Dulphy N, Toubert A. Natural killer-cell counts are associated with molecular relapse-free survival after imatinib discontinuation in chronic myeloid leukemia: the IMMUNOSTIM study. Haematologica 2017; 102:1368-1377. [PMID: 28522576 PMCID: PMC6643734 DOI: 10.3324/haematol.2017.165001] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 05/08/2017] [Indexed: 12/20/2022] Open
Abstract
Despite persistence of leukemic stem cells, patients with chronic myeloid leukemia who achieve and maintain deep molecular responses may successfully stop the tyrosine kinase inhibitor imatinib. However, questions remain unanswered regarding the biological basis of molecular relapse after imatinib cessation. In IMMUNOSTIM, we monitored 51 patients from the French Stop IMatinib trial for peripheral blood T cells and natural killer cells. Molecular relapse-free survival at 24 months was 45.1% (95% CI: 31.44%–58.75%). At the time of imatinib discontinuation, non-relapsing patients had significantly higher numbers of natural killer cells of the cytotoxic CD56dim subset than had relapsing patients, while CD56bright natural killer cells, T cells and their subsets did not differ significantly. Furthermore, the CD56dim natural killer-cell count was an independent prognostic factor of molecular-relapse free survival in a multivariate analysis. However, expression of natural killer-cell activating receptors, BCR-ABL1+ leukemia cell line K562-specific degranulation and cytokine-induced interferon-gamma secretion were decreased in non-relapsing and relapsing patients as compared with healthy individuals. After imatinib cessation, the natural killer-cell count increased significantly and stayed higher in non-relapsing patients than in relapsing patients, while receptor expression and functional properties remained unchanged. Altogether, our results suggest that natural killer cells may play a role in controlling leukemia-initiating cells at the origin of relapse after imatinib cessation, provided that these cells are numerous enough to compensate for their functional defects. Further research will decipher mechanisms underlying functional differences between natural killer cells from patients and healthy individuals and evaluate the potential interest of immunostimulatory approaches in tyrosine kinase inhibitor discontinuation strategies. (ClinicalTrial.gov Identifier NCT00478985)
Collapse
Affiliation(s)
- Delphine Rea
- INSERM UMRS-1160, Paris, France .,Service d'Hématologie Adulte, Hôpital Saint-Louis, Paris, France.,France Intergroupe des Leucémies Myéloïdes Chroniques (Fi-LMC), Institut Bergonié, Bordeaux, France
| | - Guylaine Henry
- Laboratoire d'Immunologie et Histocompatibilité, Hôpital Saint-Louis, Paris, France
| | - Zena Khaznadar
- INSERM UMRS-1160, Paris, France.,Institut Universitaire d'Hématologie, Université Paris Diderot-Paris 7, France
| | - Gabriel Etienne
- France Intergroupe des Leucémies Myéloïdes Chroniques (Fi-LMC), Institut Bergonié, Bordeaux, France.,Service d'Oncologie Médicale, Institut Bergonié, Bordeaux, France
| | - François Guilhot
- France Intergroupe des Leucémies Myéloïdes Chroniques (Fi-LMC), Institut Bergonié, Bordeaux, France.,INSERM CIC 1402, CHU de Poitiers, France
| | - Franck Nicolini
- France Intergroupe des Leucémies Myéloïdes Chroniques (Fi-LMC), Institut Bergonié, Bordeaux, France.,Service d'Hématologie Clinique, CHU Lyon Sud, Pierre Bénite, France
| | - Joelle Guilhot
- France Intergroupe des Leucémies Myéloïdes Chroniques (Fi-LMC), Institut Bergonié, Bordeaux, France.,INSERM CIC 1402, CHU de Poitiers, France
| | - Philippe Rousselot
- France Intergroupe des Leucémies Myéloïdes Chroniques (Fi-LMC), Institut Bergonié, Bordeaux, France.,Service d'Hématologie Oncologie et INSERM UMR-1173, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Françoise Huguet
- France Intergroupe des Leucémies Myéloïdes Chroniques (Fi-LMC), Institut Bergonié, Bordeaux, France.,Service d'Hématologie, IUCT Oncopole, Toulouse, France
| | - Laurence Legros
- France Intergroupe des Leucémies Myéloïdes Chroniques (Fi-LMC), Institut Bergonié, Bordeaux, France.,Service d'Hématologie Clinique, Hôpital de l'Archet, CHU de Nice, France
| | - Martine Gardembas
- France Intergroupe des Leucémies Myéloïdes Chroniques (Fi-LMC), Institut Bergonié, Bordeaux, France.,Service des Maladies du Sang, CHRU Angers, France
| | - Viviane Dubruille
- France Intergroupe des Leucémies Myéloïdes Chroniques (Fi-LMC), Institut Bergonié, Bordeaux, France.,Service d'Hématologie Clinique, Hôpital Hôtel Dieu, Nantes, France
| | - Agnès Guerci-Bresler
- France Intergroupe des Leucémies Myéloïdes Chroniques (Fi-LMC), Institut Bergonié, Bordeaux, France.,Service d'Hématologie, CHU Brabois, Vandoeuvre les Nancy, France
| | - Aude Charbonnier
- France Intergroupe des Leucémies Myéloïdes Chroniques (Fi-LMC), Institut Bergonié, Bordeaux, France.,Service d'Onco-Hématologie, Institut Paoli Calmettes, Marseille, France
| | - Frédéric Maloisel
- Groupe Oncologie-Maladies du Sang, Clinique Sainte Anne, Strasbourg, France
| | | | - Bruno Villemagne
- Service Médecine Onco-hématologie, CH de la Roche sur Yon, France
| | - François-Xavier Mahon
- France Intergroupe des Leucémies Myéloïdes Chroniques (Fi-LMC), Institut Bergonié, Bordeaux, France.,Service d'Oncologie Médicale, Institut Bergonié, Bordeaux, France
| | - Hélène Moins-Teisserenc
- INSERM UMRS-1160, Paris, France.,Laboratoire d'Immunologie et Histocompatibilité, Hôpital Saint-Louis, Paris, France.,Institut Universitaire d'Hématologie, Université Paris Diderot-Paris 7, France
| | - Nicolas Dulphy
- INSERM UMRS-1160, Paris, France .,Laboratoire d'Immunologie et Histocompatibilité, Hôpital Saint-Louis, Paris, France.,Institut Universitaire d'Hématologie, Université Paris Diderot-Paris 7, France
| | - Antoine Toubert
- INSERM UMRS-1160, Paris, France.,Laboratoire d'Immunologie et Histocompatibilité, Hôpital Saint-Louis, Paris, France.,Institut Universitaire d'Hématologie, Université Paris Diderot-Paris 7, France
| |
Collapse
|
48
|
Le Clech L, Sakka M, Meskar A, Kerspern H, Eveillard JR, Berthou C, Buors C, Lippert E, Guillerm G, Quintin-Roué I, Carré JL, Ianotto JC. The presence of monoclonal gammopathy in Ph-negative myeloproliferative neoplasms is associated with a detrimental effect on outcomes. Leuk Lymphoma 2017; 58:2582-2587. [DOI: 10.1080/10428194.2017.1312380] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Lenaïg Le Clech
- Service d’Hématologie, Institut de Cancéro-Hématologie, CHRU de Brest, Brest, France
| | - Mehdi Sakka
- Laboratoire de Biochimie, CHRU de Brest, Brest, France
| | - Ahmed Meskar
- Laboratoire de Biochimie, CHRU de Brest, Brest, France
| | | | | | - Christian Berthou
- Service d’Hématologie, Institut de Cancéro-Hématologie, CHRU de Brest, Brest, France
| | | | - Eric Lippert
- Laboratoire d’Hématologie, CHRU de Brest, Brest, France
| | - Gaelle Guillerm
- Service d’Hématologie, Institut de Cancéro-Hématologie, CHRU de Brest, Brest, France
| | | | | | | |
Collapse
|
49
|
Nicol C, Henry C, Couturier MA, Delépine P, Tripogney C, Buors C, Guillerm G, Berthou C, Tempescul A, Ianotto JC. Biosimilars of filgrastim in autologous stem cell transplantation: certain differences for myeloma patients only. Leuk Lymphoma 2017; 58:1-3. [PMID: 28278727 DOI: 10.1080/10428194.2017.1285025] [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: 10/20/2022]
Affiliation(s)
- Christophe Nicol
- a Service d'Hématologie , Institut de Cancéro-Hématologie, Hôpital Morvan, CHRU de Brest , Brest Cedex , France
| | - Chloé Henry
- b Service d'Onco-Pédiatrie , Hôpital Morvan, CHRU de Brest , Brest Cedex , France
| | - Marie-Anne Couturier
- a Service d'Hématologie , Institut de Cancéro-Hématologie, Hôpital Morvan, CHRU de Brest , Brest Cedex , France
| | - Pascal Delépine
- c Etablissement Français du Sang , Site de Brest, CHRU de Brest , Brest Cedex , France
| | - Céline Tripogney
- c Etablissement Français du Sang , Site de Brest, CHRU de Brest , Brest Cedex , France
| | - Caroline Buors
- d Laboratoire d'Hématologie , Hôpital de la Cavale Blanche, CHRU de Brest , Brest Cedex , France
| | - Gaëlle Guillerm
- a Service d'Hématologie , Institut de Cancéro-Hématologie, Hôpital Morvan, CHRU de Brest , Brest Cedex , France
| | - Christian Berthou
- a Service d'Hématologie , Institut de Cancéro-Hématologie, Hôpital Morvan, CHRU de Brest , Brest Cedex , France
| | - Adrian Tempescul
- a Service d'Hématologie , Institut de Cancéro-Hématologie, Hôpital Morvan, CHRU de Brest , Brest Cedex , France
| | - Jean-Christophe Ianotto
- a Service d'Hématologie , Institut de Cancéro-Hématologie, Hôpital Morvan, CHRU de Brest , Brest Cedex , France
| |
Collapse
|
50
|
Luque Paz D, Chauveau A, Boyer F, Buors C, Samaison L, Cottin L, Seegers V, Férec C, Le Maréchal C, Gueguen P, Lippert E, Ianotto JC, Ugo V. Sequential analysis of 18 genes in polycythemia vera and essential thrombocythemia reveals an association between mutational status and clinical outcome. Genes Chromosomes Cancer 2017; 56:354-362. [DOI: 10.1002/gcc.22437] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 12/02/2016] [Accepted: 12/03/2016] [Indexed: 12/29/2022] Open
Affiliation(s)
- Damien Luque Paz
- CHU Angers, Laboratoire d'Hématologie; Angers France
- Université d'Angers, UFR Santé; Angers France
- INSERM Unité 892, CNRS Unit 6299; Angers France
- Fédération Hospitalo-Universitaire ‘Grand Ouest Against Leukemia’ (FHU GOAL)
| | - Aurélie Chauveau
- Fédération Hospitalo-Universitaire ‘Grand Ouest Against Leukemia’ (FHU GOAL)
- CHU Brest, Laboratoire d'Hématologie; Brest France
- Université de Brest, Bretagne Occidentale, UFR Médecine; Brest France
- INSERM Unité 1078, CHRU Brest; Brest France
| | - Françoise Boyer
- Fédération Hospitalo-Universitaire ‘Grand Ouest Against Leukemia’ (FHU GOAL)
- CHU Angers, Service des Maladies du Sang; Angers France
| | - Caroline Buors
- Fédération Hospitalo-Universitaire ‘Grand Ouest Against Leukemia’ (FHU GOAL)
- CHU Brest, Laboratoire d'Hématologie; Brest France
| | | | - Laurane Cottin
- CHU Angers, Laboratoire d'Hématologie; Angers France
- Université d'Angers, UFR Santé; Angers France
- INSERM Unité 892, CNRS Unit 6299; Angers France
- Fédération Hospitalo-Universitaire ‘Grand Ouest Against Leukemia’ (FHU GOAL)
| | - Valérie Seegers
- Université d'Angers, UFR Santé; Angers France
- INSERM Unité 892, CNRS Unit 6299; Angers France
- Département de Statistique; Institut de Cancérologie de l'Ouest; Angers France
| | - Claude Férec
- Université de Brest, Bretagne Occidentale, UFR Médecine; Brest France
- INSERM Unité 1078, CHRU Brest; Brest France
- CHU Brest, Laboratoire de Génétique; Brest France
| | - Cédric Le Maréchal
- Université de Brest, Bretagne Occidentale, UFR Médecine; Brest France
- INSERM Unité 1078, CHRU Brest; Brest France
- CHU Brest, Laboratoire de Génétique; Brest France
| | - Paul Gueguen
- Université de Brest, Bretagne Occidentale, UFR Médecine; Brest France
- INSERM Unité 1078, CHRU Brest; Brest France
- CHU Brest, Laboratoire de Génétique; Brest France
| | - Eric Lippert
- Fédération Hospitalo-Universitaire ‘Grand Ouest Against Leukemia’ (FHU GOAL)
- CHU Brest, Laboratoire d'Hématologie; Brest France
- Université de Brest, Bretagne Occidentale, UFR Médecine; Brest France
- INSERM Unité 1078, CHRU Brest; Brest France
| | - Jean-Christophe Ianotto
- Fédération Hospitalo-Universitaire ‘Grand Ouest Against Leukemia’ (FHU GOAL)
- CHU Brest, Service d'Hématologie Clinique; Brest France
| | - Valérie Ugo
- CHU Angers, Laboratoire d'Hématologie; Angers France
- Université d'Angers, UFR Santé; Angers France
- INSERM Unité 892, CNRS Unit 6299; Angers France
- Fédération Hospitalo-Universitaire ‘Grand Ouest Against Leukemia’ (FHU GOAL)
| |
Collapse
|