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Raskovalova T, Jacob MC, Park S. Flow cytometric analysis of peripheral blood neutrophil myeloperoxidase expression in myelodysplastic neoplasms. Leukemia 2024; 38:923-924. [PMID: 38486127 DOI: 10.1038/s41375-024-02223-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 04/07/2024]
Affiliation(s)
- Tatiana Raskovalova
- Laboratoire d'immunologie, Université Grenoble Alpes, Grenoble University Hospital, Grenoble, France.
- Institute for Advanced Biosciences (IAB), INSERM U1209, CNRS UMR 5309, Université Grenoble Alpes, Grenoble, France.
| | - Marie-Christine Jacob
- Laboratoire d'immunologie, Université Grenoble Alpes, Grenoble University Hospital, Grenoble, France
- Institute for Advanced Biosciences (IAB), INSERM U1209, CNRS UMR 5309, Université Grenoble Alpes, Grenoble, France
| | - Sophie Park
- Institute for Advanced Biosciences (IAB), INSERM U1209, CNRS UMR 5309, Université Grenoble Alpes, Grenoble, France
- Service d'Hématologie, Université Grenoble Alpes, Grenoble University Hospital, Grenoble, France
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Lo Presti C, Szymanski G, Lefebvre C, Jacob MC, Mossuz P, Gil H. Aleukemic congenital leukemia cutis preceding monocytic leukemia with favorable outcome: A case report. EJHaem 2024; 5:162-165. [PMID: 38406553 PMCID: PMC10887267 DOI: 10.1002/jha2.861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 01/22/2024] [Indexed: 02/27/2024]
Abstract
A newborn girl had typical "blueberry muffin" skin lesions, which shows histopathologic features of monocytic leukemia cutis. The systemic leukemia was demonstrated after one month of life. She was treated by chemotherapy, including induction and three consolidation cures, according to the ELAM02 protocol, which led to complete remission. This case report with congenital form of AML5 cutaneous localization, preceding systemic involvement, with a 5-year follow-up and positive outcome is remarkable.
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Affiliation(s)
- Caroline Lo Presti
- Department of Biological Hematology Grenoble Alpes University Hospital Grenoble France
| | - Gautier Szymanski
- Department of Biological Hematology Grenoble Alpes University Hospital Grenoble France
| | - Christine Lefebvre
- Department of Biological Hematology Grenoble Alpes University Hospital Grenoble France
| | | | - Pascal Mossuz
- Department of Biological Hematology Grenoble Alpes University Hospital Grenoble France
| | - Hugo Gil
- Department of Anatomo-Cytopathology Grenoble Alpes University Hospital Grenoble France
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Phelippeau M, Lefebvre C, Jacob MC, Syrykh C, Ghelfi J, Carras S, Laurent C, Molina L, Valmary-Degano S. [Dasatinib-induced follicular lymphoid hyperplasia, an entity to know]. Ann Pathol 2023; 43:45-51. [PMID: 36266200 DOI: 10.1016/j.annpat.2022.09.005] [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: 12/20/2021] [Revised: 07/30/2022] [Accepted: 09/14/2022] [Indexed: 11/05/2022]
Abstract
Follicular lymphoid hyperplasia induced by dasatinib is an entity recently described. It is sometimes difficult to rule out the diagnostic of small B-cell lymphoma. Usually, the node is swollen, with follicular architecture conserved, composed by germinal centers with variable size and shape, with a hight number of mitoses and tingible bodies macrophages inside. Follicular lymphoid hyperplasia is isolated or associated with multiple reactive patterns. The immunohistochemical profil of germinal centers is CD20+, CD10+, BCL6+, BCL2-. Swollen node disappears in a short time after dasatinib discontinuation. Clinicians and pathologists need to be aware of this entity, so as not to avoid mistakenly suspect lymphoma when lymphadenopathy occurs in a patient with chronic myeloid leukemia treated with dasatinib.
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Affiliation(s)
- Mona Phelippeau
- Service d'anatomie et cytologie pathologiques, CHU de Grenoble-Alpes, 38000 Grenoble, France
| | - Christine Lefebvre
- Laboratoire d'hématologie, CHU de Grenoble-Alpes, 38000 Grenoble, France
| | | | - Charlotte Syrykh
- Service d'anatomie et cytologie pathologiques, Institut Universitaire du Cancer de Toulouse Toulouse - Oncopole, 31000 Toulouse, France
| | - Julien Ghelfi
- Departement de radiologie, CHU de Grenoble-Alpes, 38000 Grenoble, France
| | - Sylvain Carras
- Laboratoire d'hématologie, CHU de Grenoble-Alpes, 38000 Grenoble, France; Université de Grenoble-Alpes, Inserm U1209, CNRS UMR5309, Institut pour l'avancée des biosciences (IAB), 38000 Grenoble, France; Service d'hématologie, Centre Hospitalo-Universitaire de Grenoble-Alpes, 38000 Grenoble, France
| | - Camille Laurent
- Service d'anatomie et cytologie pathologiques, Institut Universitaire du Cancer de Toulouse Toulouse - Oncopole, 31000 Toulouse, France
| | - Lysiane Molina
- Service d'hématologie, Centre Hospitalo-Universitaire de Grenoble-Alpes, 38000 Grenoble, France
| | - Séverine Valmary-Degano
- Service d'anatomie et cytologie pathologiques, CHU de Grenoble-Alpes, 38000 Grenoble, France; Université de Grenoble-Alpes, Inserm U1209, CNRS UMR5309, Institut pour l'avancée des biosciences (IAB), 38000 Grenoble, France.
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Raskovalova T, Scheffen L, Jacob MC, Vettier C, Bulabois B, Szymanski G, Chevalier S, Gonnet N, Park S, Labarère J. Comparative diagnostic accuracy between simplified and original flow cytometric gating strategies for peripheral blood neutrophil myeloperoxidase expression in ruling out myelodysplastic syndromes. PLoS One 2022; 17:e0276095. [PMCID: PMC9674135 DOI: 10.1371/journal.pone.0276095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 09/29/2022] [Indexed: 11/19/2022] Open
Abstract
Background Flow cytometric analysis of peripheral blood neutrophil myeloperoxidase expression is accurate in ruling out myelodyplastic syndromes (MDS) but might not be suitable for implementation in busy clinical laboratories. We aimed to simplify the original gating strategy and examine its accuracy. Methods Using the individual data from 62 consecutive participants enrolled in a prospective validation study, we assessed the agreement in intra-individual robust coefficient of variation (RCV) of peripheral blood neutrophil myeloperoxidase expression and compared diagnostic accuracy between the simplified and original gating strategies. Results Cytomorphological evaluation of bone marrow aspirate confirmed MDS in 23 patients (prevalence, 37%), unconfirmed MDS in 32 patients (52%), and was uninterpretable in 7 patients (11%). Median intra-individual RCV for simplified and original gating strategies were 30.7% (range, 24.7–54.4) and 30.6% (range, 24.7–54.1), with intra-class correlation coefficient quantifying absolute agreement equal to 1.00 (95% confidence interval [CI], 0.99 to 1.00). The areas under the receiver operating characteristic (ROC) curves were 0.93 (95% CI, 0.82–0.98) and 0.92 (95% CI, 0.82–0.98), respectively (P = .32). Using simplified or original gating strategy, intra-individual RCV values lower than a pre-specified threshold of 30.0% ruled out MDS for 35% (19 of 55) patients, with both sensitivity and negative predictive value estimates of 100%. Conclusions The simplified gating strategy performs as well as the original one for ruling out MDS and has the potential to save time and reduce resource utilization. Yet, prospective validation of the simplified gating strategy is warranted before its adoption in routine. Trial registration ClinicalTrials.gov Identifier: NCT03363399 (First posted on December 6, 2017).
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Affiliation(s)
- Tatiana Raskovalova
- Institute for Advanced Biosciences, INSERM U1209, CNRS UMR 5309, Université Grenoble Alpes, Grenoble, France
- Laboratoire d’Immunologie, Grenoble University Hospital, Grenoble, France
- * E-mail:
| | - Laura Scheffen
- Institute for Advanced Biosciences, INSERM U1209, CNRS UMR 5309, Université Grenoble Alpes, Grenoble, France
| | - Marie-Christine Jacob
- Institute for Advanced Biosciences, INSERM U1209, CNRS UMR 5309, Université Grenoble Alpes, Grenoble, France
- Laboratoire d’Immunologie, Grenoble University Hospital, Grenoble, France
| | - Claire Vettier
- Laboratoire d’Hématologie Biologique, Grenoble University Hospital, Grenoble, France
| | - Bénédicte Bulabois
- Laboratoire d’Hématologie Biologique, Grenoble University Hospital, Grenoble, France
| | - Gautier Szymanski
- Laboratoire d’Hématologie Biologique, Grenoble University Hospital, Grenoble, France
| | - Simon Chevalier
- Laboratoire d’Hématologie Biologique, Grenoble University Hospital, Grenoble, France
| | - Nicolas Gonnet
- CIC 1406, INSERM, Université Grenoble Alpes, Grenoble University Hospital, Grenoble, France
| | - Sophie Park
- Institute for Advanced Biosciences, INSERM U1209, CNRS UMR 5309, Université Grenoble Alpes, Grenoble, France
- Clinique Universitaire d’Hématologie, Grenoble University Hospital, Grenoble, France
| | - José Labarère
- Clinical Epidemiology Unit, Grenoble University Hospital, Grenoble, France
- TIMC-IMAG, UMR 5525, CNRS, Université Grenoble Alpes, Grenoble, France
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Raskovalova T, Scheffen L, Jacob MC, Chevalier S, Tondeur S, Bulabois B, Meunier M, Szymanski G, Lefebvre C, Planta C, Dumestre-Perard C, Gonnet N, Garban F, Merle R, Park S, Labarère J. Flow cytometry lyophilised-reagent tube for quantifying peripheral blood neutrophil myeloperoxidase expression in myelodysplastic syndromes (MPO-MDS-Develop): protocol for a diagnostic accuracy study. BMJ Open 2022; 12:e065850. [PMID: 36207039 PMCID: PMC9557768 DOI: 10.1136/bmjopen-2022-065850] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Suspicion of myelodysplastic syndromes (MDS) is the most common reason for bone marrow aspirate in elderly patients. Peripheral blood neutrophil myeloperoxidase expression quantified by flow cytometric analysis might rule out MDS for up to 35% of patients referred for suspected disease, without requiring bone marrow aspiration. Yet laboratory-developed liquid antibody cocktails have practical limitations, because of lack of standardisation and poor stability. This research project aims to estimate the level of agreement and comparative accuracy between a single-use flow cytometry tube of lyophilised reagents (BD Lyotube Stain 468) and its laboratory-developed liquid reagent counterpart in quantifying peripheral blood neutrophil myeloperoxidase expression, among adult patients referred for suspected MDS. METHODS AND ANALYSIS The MPO-MDS-Develop project is a cross-sectional diagnostic accuracy study of two index tests by comparison with a reference standard in consecutive unselected adult patients conducted at a single university hospital. Flow cytometry analysis of peripheral blood samples will be performed by independent operators blinded to the reference diagnosis, using either Lyotube Stain 468 or laboratory-developed liquid reagent cocktail. The reference diagnosis of MDS will be established by cytomorphological evaluation of bone marrow aspirate by two independent haematopathologists blinded to the index test results. Morphologic assessment will be complemented by bone marrow flow cytometric score, karyotype and targeted next-generation sequencing panel of 43 genes, where relevant. The target sample size is 103 patients. ETHICS AND DISSEMINATION An institutional review board (Comité de Protection des Personnes Sud Est III, Lyon, France) approved the protocol prior to study initiation (reference number: 2020-028-B). Participants will be recruited using an opt-out approach. Efforts will be made to release the primary results within 6 months of study completion. TRIAL REGISTRATION NUMBER NCT04399018.
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Affiliation(s)
- Tatiana Raskovalova
- Laboratoire d'Immunologie, Grenoble Alpes University Hospital, Grenoble, France
- Institute for Advanced Biosciences (IAB), INSERM U1209, CNRS UMR 5309, Univ. Grenoble Alpes, Grenoble, France
| | - Laura Scheffen
- Laboratoire d'Immunologie, Grenoble Alpes University Hospital, Grenoble, France
| | - Marie-Christine Jacob
- Laboratoire d'Immunologie, Grenoble Alpes University Hospital, Grenoble, France
- Institute for Advanced Biosciences (IAB), INSERM U1209, CNRS UMR 5309, Univ. Grenoble Alpes, Grenoble, France
| | - Simon Chevalier
- Laboratoire d'Hématologie Biologique, Grenoble Alpes University Hospital, Grenoble, France
| | - Sylvie Tondeur
- Laboratoire d'Hématologie Biologique, Grenoble Alpes University Hospital, Grenoble, France
| | - Bénédicte Bulabois
- Laboratoire d'Hématologie Biologique, Grenoble Alpes University Hospital, Grenoble, France
| | - Mathieu Meunier
- Institute for Advanced Biosciences (IAB), INSERM U1209, CNRS UMR 5309, Univ. Grenoble Alpes, Grenoble, France
- Clinique Universitaire d'Hématologie, Grenoble Alpes University Hospital, Grenoble, France
| | - Gautier Szymanski
- Laboratoire d'Hématologie Biologique, Grenoble Alpes University Hospital, Grenoble, France
| | - Christine Lefebvre
- Laboratoire d'Hématologie Biologique, Grenoble Alpes University Hospital, Grenoble, France
| | - Charlotte Planta
- Laboratoire d'Immunologie, Grenoble Alpes University Hospital, Grenoble, France
| | | | - Nicolas Gonnet
- CIC 1406, INSERM, Grenoble Alpes University Hospital, Univ. Grenoble Alpes, Grenoble, France
| | - Frédéric Garban
- Clinique Universitaire d'Hématologie, Grenoble Alpes University Hospital, Grenoble, France
- TIMC, UMR 5525, CNRS, Univ. Grenoble Alpes, Grenoble, France
| | - Raymond Merle
- Département Universitaire des Patients, Univ. Grenoble Alpes, Grenoble, France
| | - Sophie Park
- Institute for Advanced Biosciences (IAB), INSERM U1209, CNRS UMR 5309, Univ. Grenoble Alpes, Grenoble, France
- Clinique Universitaire d'Hématologie, Grenoble Alpes University Hospital, Grenoble, France
| | - José Labarère
- TIMC, UMR 5525, CNRS, Univ. Grenoble Alpes, Grenoble, France
- Clinical Epidemiology Unit, Grenoble Alpes University Hospital, Grenoble, France
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Clavarino G, Leroy C, Epaulard O, Raskovalova T, Vilotitch A, Pernollet M, Dumestre-Pérard C, Defendi F, Le Maréchal M, Le Gouellec A, Audoin P, Bosson JL, Poignard P, Roustit M, Jacob MC, Cesbron JY. Fine Analysis of Lymphocyte Subpopulations in SARS-CoV-2 Infected Patients: Differential Profiling of Patients With Severe Outcome. Front Immunol 2022; 13:889813. [PMID: 35911748 PMCID: PMC9335884 DOI: 10.3389/fimmu.2022.889813] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/27/2022] [Indexed: 11/13/2022] Open
Abstract
COVID-19 is caused by the human pathogen severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has resulted in widespread morbidity and mortality. CD4+ T cells, CD8+ T cells and neutralizing antibodies all contribute to control SARS-CoV-2 infection. However, heterogeneity is a major factor in disease severity and in immune innate and adaptive responses to SARS-CoV-2. We performed a deep analysis by flow cytometry of lymphocyte populations of 125 hospitalized SARS-CoV-2 infected patients on the day of hospital admission. Five clusters of patients were identified using hierarchical classification on the basis of their immunophenotypic profile, with different mortality outcomes. Some characteristics were observed in all the clusters of patients, such as lymphopenia and an elevated level of effector CD8+CCR7- T cells. However, low levels of T cell activation are associated to a better disease outcome; on the other hand, profound CD8+ T-cell lymphopenia, a high level of CD4+ and CD8+ T-cell activation and a high level of CD8+ T-cell senescence are associated with a higher mortality outcome. Furthermore, a cluster of patient was characterized by high B-cell responses with an extremely high level of plasmablasts. Our study points out the prognostic value of lymphocyte parameters such as T-cell activation and senescence and strengthen the interest in treating the patients early in course of the disease with targeted immunomodulatory therapies based on the type of adaptive response of each patient.
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Affiliation(s)
- Giovanna Clavarino
- Laboratoire d’Immunologie, Pôle de Biologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- *Correspondence: Giovanna Clavarino,
| | - Corentin Leroy
- Cellule d’Ingénierie des Données, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- Centre d’Investigation Clinique de l’Innovation et de la Technologie (CIC-IT), Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Olivier Epaulard
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- Univ. Grenoble Alpes, CNRS, Grenoble INP, TIMC, Grenoble, France
| | - Tatiana Raskovalova
- Laboratoire d’Immunologie, Pôle de Biologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Antoine Vilotitch
- Cellule d’Ingénierie des Données, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Martine Pernollet
- Laboratoire d’Immunologie, Pôle de Biologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Chantal Dumestre-Pérard
- Laboratoire d’Immunologie, Pôle de Biologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- Univ. Grenoble Alpes, CNRS, CEA, Institut de Biologie Structurale, Grenoble, France
| | - Federica Defendi
- Laboratoire d’Immunologie, Pôle de Biologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Marion Le Maréchal
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Audrey Le Gouellec
- Univ. Grenoble Alpes, CNRS, Grenoble INP, TIMC, Grenoble, France
- Service de Biochimie Biologie Moléculaire et Toxicologie Environnementale, Pôle de Biologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Pierre Audoin
- Unité recherche, Pôle de Biologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Jean-Luc Bosson
- Univ. Grenoble Alpes, CNRS, Grenoble INP, TIMC, Grenoble, France
| | - Pascal Poignard
- Univ. Grenoble Alpes, CNRS, CEA, Institut de Biologie Structurale, Grenoble, France
- Laboratoire de Virologie, Pôle de Biologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Matthieu Roustit
- Centre d’Investigation Clinique INSERM CIC1406, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- Univ. Grenoble Alpes, INSERM, UMR 1300, HP2, Grenoble, France
| | - Marie-Christine Jacob
- Laboratoire d’Immunologie, Pôle de Biologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Jean-Yves Cesbron
- Laboratoire d’Immunologie, Pôle de Biologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
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Defendi F, Leroy C, Epaulard O, Clavarino G, Vilotitch A, Le Marechal M, Jacob MC, Raskovalova T, Pernollet M, Le Gouellec A, Bosson JL, Poignard P, Roustit M, Thielens N, Dumestre-Pérard C, Cesbron JY. Complement Alternative and Mannose-Binding Lectin Pathway Activation Is Associated With COVID-19 Mortality. Front Immunol 2021; 12:742446. [PMID: 34567008 PMCID: PMC8461024 DOI: 10.3389/fimmu.2021.742446] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/23/2021] [Indexed: 12/19/2022] Open
Abstract
Background The SARS-CoV-2 infection triggers excessive immune response resulting in increased levels of pro-inflammatory cytokines, endothelial injury, and intravascular coagulopathy. The complement system (CS) activation participates to this hyperinflammatory response. However, it is still unclear which activation pathways (classical, alternative, or lectin pathway) pilots the effector mechanisms that contribute to critical illness. To better understand the immune correlates of disease severity, we performed an analysis of CS activation pathways and components in samples collected from COVID-19 patients hospitalized in Grenoble Alpes University Hospital between 1 and 30 April 2020 and of their relationship with the clinical outcomes. Methods We conducted a retrospective, single-center study cohort in 74 hospitalized patients with RT-PCR-proven COVID-19. The functional activities of classical, alternative, and mannose-binding lectin (MBL) pathways and the antigenic levels of the individual components C1q, C4, C3, C5, Factor B, and MBL were measured in patients' samples during hospital admission. Hierarchical clustering with the Ward method was performed in order to identify clusters of patients with similar characteristics of complement markers. Age was included in the model. Then, the clusters were compared with the patient clinical features: rate of intensive care unit (ICU) admission, corticoid treatment, oxygen requirement, and mortality. Results Four clusters were identified according to complement parameters. Among them, two clusters revealed remarkable profiles: in one cluster (n = 15), patients exhibited activation of alternative and lectin pathways and low antigenic levels of MBL, C4, C3, Factor B, and C5 compared to all the other clusters; this cluster had the higher proportion of patients who died (27%) and required oxygen support (80%) or ICU care (53%). In contrast, the second cluster (n = 19) presented inflammatory profile with high classical pathway activity and antigenic levels of complement components; a low proportion of patients required ICU care (26%) and no patient died in this group. Conclusion These findings argue in favor of prominent activation of the alternative and MBL complement pathways in severe COVID-19, but the spectrum of complement involvement seems to be heterogeneous requiring larger studies.
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Affiliation(s)
- Federica Defendi
- Laboratoire d’Immunologie, Institut de Biologie et Pathologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Corentin Leroy
- Cellule d’Ingénierie des Données, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- Centre d’Investigation Clinique de l’Innovation et de la Technologie (CIC-IT), Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Olivier Epaulard
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- Université Grenoble Alpes, TIMC-IMAG, Grenoble, France
| | - Giovanna Clavarino
- Laboratoire d’Immunologie, Institut de Biologie et Pathologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Antoine Vilotitch
- Cellule d’Ingénierie des Données, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Marion Le Marechal
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Marie-Christine Jacob
- Laboratoire d’Immunologie, Institut de Biologie et Pathologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Tatiana Raskovalova
- Laboratoire d’Immunologie, Institut de Biologie et Pathologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Martine Pernollet
- Laboratoire d’Immunologie, Institut de Biologie et Pathologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Audrey Le Gouellec
- Université Grenoble Alpes, TIMC-IMAG, Grenoble, France
- Laboratoire de Biochimie, Institut de Biologie et Pathologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | | | - Pascal Poignard
- Université Grenoble Alpes, CNRS, CEA, Institut de Biologie Structurale (IBS), Grenoble, France
- Laboratoire de Virologie, Institut de Biologie et Pathologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Matthieu Roustit
- Département de Pharmacologie Clinique INSERM CIC 1406, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- Université Grenoble Alpes, UMR 1042-HP2, INSERM, Grenoble, France
| | - Nicole Thielens
- Université Grenoble Alpes, CNRS, CEA, Institut de Biologie Structurale (IBS), Grenoble, France
| | - Chantal Dumestre-Pérard
- Laboratoire d’Immunologie, Institut de Biologie et Pathologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- Université Grenoble Alpes, CNRS, CEA, Institut de Biologie Structurale (IBS), Grenoble, France
| | - Jean-Yves Cesbron
- Laboratoire d’Immunologie, Institut de Biologie et Pathologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
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Bouroumeau A, Bussot L, Bonnefoix T, Fournier C, Chapusot C, Casasnovas O, Martin L, McLeer A, Col E, David-Boudet L, Lefebvre C, Algrin C, Raskovalova T, Jacob MC, Vettier C, Chevalier S, Callanan MB, Gressin R, Emadali A, Sartelet H. c-MYC and p53 expression highlight starry-sky pattern as a favourable prognostic feature in R-CHOP-treated diffuse large B-cell lymphoma. J Pathol Clin Res 2021; 7:604-615. [PMID: 34374220 PMCID: PMC8503894 DOI: 10.1002/cjp2.223] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 12/20/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is a clinically heterogeneous entity, in which the first-line treatment currently consists of an immuno-chemotherapy regimen (R-CHOP). However, around 30% of patients will not respond or will relapse. Overexpression of c-MYC or p53 is frequently found in DLBCL, but an association with prognosis remains controversial, as for other biomarkers previously linked with DLBCL aggressivity (CD5, CD23, or BCL2). The aim of this study was to explore the expression of these biomarkers and their correlation with outcome, clinical, or pathological features in a DLBCL cohort. Immunohistochemical (c-MYC, p53, BCL2, CD5, and CD23), morphological ('starry-sky' pattern [SSP]), targeted gene panel sequencing by next-generation sequencing (NGS), and fluorescence in situ hybridisation analyses were performed on tissue microarray blocks for a retrospective cohort of 94 R-CHOP-treated de novo DLBCL. In univariate analyses, p53 overexpression (p53high ) was associated with unfavourable outcome (p = 0.04) and with c-MYC overexpression (p = 0.01), whereas c-MYC overexpression was linked with an SSP (p = 0.004), but only tended towards an inferior prognosis (p = 0.06). Presence of a starry-sky morphology was found to be correlated with better survival in p53high DLBCL (p = 0.03) and/or c-MYC-positive DLBCL (p = 0.002). Furthermore, NGS data revealed that these three variables were associated with somatic mutations (PIM1, TNFRSF14, FOXO1, and B2M) involved in B-cell proliferation, survival, metabolism, and immune signalling. Taken together, these results show that the SSP pattern seems to be a protective factor in high-risk DLBCL subgroups and highlight cell death as a built-in failsafe mechanism to control tumour growth.
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Affiliation(s)
- Antonin Bouroumeau
- Department of Pathology, Grenoble-Alpes University Hospital, Grenoble, France.,Institute for Advanced Biosciences, INSERM U1209/CNRS UMR 5309/Grenoble-Alpes University, Grenoble, France.,Division of Clinical Pathology, Diagnostic Department, Hôpitaux Universitaires Genève, Geneva, Switzerland
| | - Lucile Bussot
- Department of Clinical Hematology, Grenoble-Alpes University Hospital, Grenoble, France
| | - Thierry Bonnefoix
- Institute for Advanced Biosciences, INSERM U1209/CNRS UMR 5309/Grenoble-Alpes University, Grenoble, France.,Pole Recherche, Grenoble-Alpes University Hospital, Grenoble, France
| | - Cyril Fournier
- University of Bourgogne, INSERM 1231, Dijon, France.,Unit for Innovation in Genetics and Epigenetics in Oncology, Dijon University Hospital, Dijon, France
| | | | - Olivier Casasnovas
- Department of Clinical Hematology, Dijon University Hospital, Dijon, France
| | - Laurent Martin
- Department of Pathology, Dijon University Hospital, Dijon, France
| | - Anne McLeer
- Department of Pathology, Grenoble-Alpes University Hospital, Grenoble, France.,Institute for Advanced Biosciences, INSERM U1209/CNRS UMR 5309/Grenoble-Alpes University, Grenoble, France
| | - Edwige Col
- Department of Pathology, Grenoble-Alpes University Hospital, Grenoble, France
| | | | - Christine Lefebvre
- Hematology, Oncogenetics and Immunology Unit, Grenoble-Alpes University Hospital, Grenoble, France
| | | | - Tatiana Raskovalova
- Hematology, Oncogenetics and Immunology Unit, Grenoble-Alpes University Hospital, Grenoble, France
| | - Marie-Christine Jacob
- Hematology, Oncogenetics and Immunology Unit, Grenoble-Alpes University Hospital, Grenoble, France
| | - Claire Vettier
- Hematology, Oncogenetics and Immunology Unit, Grenoble-Alpes University Hospital, Grenoble, France
| | - Simon Chevalier
- Hematology, Oncogenetics and Immunology Unit, Grenoble-Alpes University Hospital, Grenoble, France
| | - Mary B Callanan
- University of Bourgogne, INSERM 1231, Dijon, France.,Unit for Innovation in Genetics and Epigenetics in Oncology, Dijon University Hospital, Dijon, France
| | - Rémy Gressin
- Department of Clinical Hematology, Grenoble-Alpes University Hospital, Grenoble, France
| | - Anouk Emadali
- Institute for Advanced Biosciences, INSERM U1209/CNRS UMR 5309/Grenoble-Alpes University, Grenoble, France.,Pole Recherche, Grenoble-Alpes University Hospital, Grenoble, France
| | - Hervé Sartelet
- Department of Pathology, Grenoble-Alpes University Hospital, Grenoble, France.,Department of Pathology, Nancy Regional University Hospital, Nancy, France
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9
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Raskovalova T, Jacob MC, Bulabois CE, Mariette C, Scheffen L, Park S, Labarère J. Flow cytometric analysis of peripheral blood neutrophil myeloperoxidase expression for ruling out myelodysplastic syndromes: a prospective validation study. Ann Hematol 2021; 100:1149-1158. [PMID: 33569703 DOI: 10.1007/s00277-021-04446-7] [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: 09/28/2020] [Accepted: 02/01/2021] [Indexed: 12/25/2022]
Abstract
Suspicion of myelodysplastic syndromes (MDS) is the most common reason for bone marrow aspirate in elderly patients. This study aimed to prospectively validate the accuracy for flow cytometric analysis of peripheral blood neutrophil myeloperoxidase expression in ruling out MDS. We enrolled 62 consecutive patients who were referred for suspected MDS, based on medical history and peripheral blood cytopenia. The accuracy of intra-individual robust coefficient of variation (RCV) for peripheral blood neutrophil myeloperoxidase expression was assessed with a prespecified 30% threshold. Cytomorphological evaluation of bone marrow aspirate performed by experienced hematopathologists confirmed MDS in 23 patients (prevalence, 37%), unconfirmed MDS in 32 patients (52%, including 3 patients with idiopathic cytopenia of undetermined significance (ICUS)), and was uninterpretable in 7 patients (11%). The median intra-individual RCV values for neutrophil myeloperoxidase expression in peripheral blood were 37.4% (range, 30.7-54.1), 29.2% (range, 28.1-32.1), and 29.1% (range, 24.7-37.8) for patients with confirmed suspicion of MDS, ICUS, and unconfirmed suspicion of MDS, respectively (P<0.001). The area under the ROC curve was 0.92 (95% confidence interval, 0.86-0.99). An intra-individual RCV value lower than 30% ruled out MDS for 35% (i.e., 19/55) patients referred for suspected disease, with 100% sensitivity (95% CI, 85-100%) and 100% negative predictive value (95% CI, 82-100%) estimates. This study shows that flow cytometric analysis of peripheral blood neutrophil myeloperoxidase expression might obviate the need for bone marrow aspirate for 35% of patients with suspected MDS. Trial registration: ClinicalTrials.gov identifier: NCT03363399 (first posted on December 6, 2017).
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Affiliation(s)
- Tatiana Raskovalova
- Laboratoire d'immunologie, Centre Hospitalier Universitaire Grenoble Alpes, CS 10217, F-38043, Grenoble Cedex 9, France.
| | - Marie-Christine Jacob
- Laboratoire d'immunologie, Centre Hospitalier Universitaire Grenoble Alpes, CS 10217, F-38043, Grenoble Cedex 9, France
| | - Claude-Eric Bulabois
- Clinique Universitaire d'Hématologie, Grenoble University Hospital, F-38043, Grenoble, France
| | - Clara Mariette
- Clinique Universitaire d'Hématologie, Grenoble University Hospital, F-38043, Grenoble, France
| | - Laura Scheffen
- Laboratoire d'immunologie, Centre Hospitalier Universitaire Grenoble Alpes, CS 10217, F-38043, Grenoble Cedex 9, France
| | - Sophie Park
- Clinique Universitaire d'Hématologie, Grenoble University Hospital, F-38043, Grenoble, France.,Institute for Advanced Biosciences (IAB), INSERM U1209, CNRS UMR 5309, Université Grenoble Alpes, Grenoble, France
| | - José Labarère
- Quality of Care Unit, INSERM CIC 1406, Grenoble University Hospital, F-38043, Grenoble, France.,TIMC-IMAG, UMR 5525, CNRS, Université Grenoble Alpes, F-38043, Grenoble, France
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10
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11
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Debliquis A, Baseggio L, Bouyer S, Guy J, Garnache-Ottou F, Genevieve F, Mayeur-Rousse C, Letestu R, Chapuis N, Harrivel V, Bennani H, Lachot S, Loosveld M, Nicolino-Brunet C, Pérès M, Roussel M, Veyrat-Masson R, Jacob MC, Drenou B. Multicentric MFI30 study: Standardization of flow cytometry analysis of CD30 expression in non-Hodgkin lymphoma. Cytometry B Clin Cytom 2020; 100:488-496. [PMID: 32803917 DOI: 10.1002/cyto.b.21940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/15/2020] [Accepted: 07/15/2020] [Indexed: 02/03/2023]
Abstract
CD30 transmembrane receptor, a member of the tumor necrosis factor receptor family, is expressed in different lymphomas. Brentuximab vedotin (BV), a CD30 monoclonal antibody (Ab)-drug conjugate, is effective in CD30-positive lymphomas. However, the response to BV is not always correlated to CD30 expression detected by immunohistochemistry (IHC). The objectives of this study were to standardize and evaluate CD30 intensity by flow cytometry (FCM) in non-Hodgkin's lymphomas. Twelve centers analyzed 161 cases on standardized cytometers using normalized median fluorescence intensity (nMFI30) of three different Abs, of which one clone can recognize the same epitope as BV. FCM distinguished four groups of cases: negative group (n = 110) which showed no expression with the three clones; high positive group (n = 13) which gave nMFI30 > 5% with all tested clones; dim positive group (n = 17) which showed nMFI30 > 1% with all tested clones and <5% for at least one; discordant group (n = 21) with positive and negative expression of the different clones. In consistency with the literature, CD30 was positive in all anaplastic large cell lymphomas, in some diffuse large B-cell lymphomas (DLBCL), and in other rare lymphomas. FCM results were concordant with those of IHC in 77% of cases. Discrepancies could be explained by clones-related differences, microenvironment, or intracytoplasmic staining. Interestingly, FCM was more sensitive than IHC in 11% of cases, especially in DLBCL. Multicenter standardized FCM of specific CD30 could improve case detection and extend the treatment of BV to various CD30-positive lymphomas.
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Affiliation(s)
- Agathe Debliquis
- Laboratoire d'Hématologie, Groupe Hospitalier de la région Mulhouse Sud Alsace, Mulhouse, France
| | - Lucile Baseggio
- Laboratoire d'Hématologie Cellulaire, Groupement Hospitalier Sud/Hospices Civils de Lyon, Lyon, France
| | - Sabrina Bouyer
- Service d'Hématologie Biologique, Center Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Julien Guy
- Service d'Hématologie biologique, Center Hospitalier Universitaire de Dijon, Dijon, France
| | | | - Franck Genevieve
- Laboratoire d'Hématologie, Center Hospitalier Universitaire d'Angers, Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), Angers, France
| | - Caroline Mayeur-Rousse
- Laboratoire d'Hématologie, Center Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - Remi Letestu
- Service d'Hématologie Biologique, Hôpital Avicenne HUPSSD, AP-HP, Bobigny, France
| | - Nicolas Chapuis
- Service d'Hématologie Biologique, Hopital Cochin APHP, Paris, France
| | | | - Hind Bennani
- Laboratoire de biologie, Hopital Foch, Suresnes, France
| | - Sebastien Lachot
- Service d'Hématologie Biologie, Center Hospitalier Universitaire de Tours, Tours, France
| | - Marie Loosveld
- Laboratoire d'Hématologie, Center Hospitalier Universitaire de Marseille, CNRS, INSERM, CIML, Aix Marseille Université, Marseille, France
| | - Corinne Nicolino-Brunet
- Laboratoire d'Hématologie et Biologie Vasculaire du Pr Françoise Dignat George, Center Hospitalier Universitaire La Conception, Marseille, France
| | - Michaël Pérès
- Laboratoire d'Hématologie, IUCT-Oncopole, CHU de Toulouse, Toulouse, France
| | - Mikael Roussel
- Pôle Biologie, Center Hospitalier Universitaire de Rennes, Rennes, France
| | - Richard Veyrat-Masson
- Service d'Hématologie Biologique, Hôpital Estaing, Center Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Marie-Christine Jacob
- Laboratoire d'Immunologie, Center Hospitalier Universitaire de Grenoble-Alpes, La Tronche, France
| | - Bernard Drenou
- Laboratoire d'Hématologie, Groupe Hospitalier de la région Mulhouse Sud Alsace, Mulhouse, France
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12
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Bouroumeau A, Kaphan E, Legrand C, Raskovalova T, Szymanski G, Vettier C, Lefebvre C, Jacob MC, McLeer A, Peuchmaur M, Gressin R, Sartelet H. Transformation of a low-grade follicular lymphoma into a composite lymphoma combining a high-grade B-cell lymphoma and a lymphoblastic neoplasm expressing Terminal deoxynucleotidyl Transferase: a case report. J Med Case Rep 2020; 14:117. [PMID: 32713346 PMCID: PMC7384216 DOI: 10.1186/s13256-020-02433-6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 06/04/2020] [Indexed: 12/11/2022] Open
Abstract
Background High-grade B-cell lymphoma with rearrangements of MYC and BCL2 and/or BCL6 is an aggressive mature B-cell neoplasm, whereas B-lymphoblastic lymphoma is immature cell proliferation, with a frequent positivity for terminal deoxynucleotidyl transferase. The transformation of a low-grade follicular lymphoma into a lymphoblastic neoplasm expressing terminal deoxynucleotidyl transferase is a very rare event. Case presentation A 55-year-old Caucasian man was followed for a grade 1–2 follicular lymphoma carrying a t(14;18) IGH/BCL2+ and was initially treated with R-CHOP. The follicular lymphoma presented two relapses. In the third relapse, the patient had multiple lymphadenopathy and ascites, which motivated a retroperitoneal biopsy and an ascitic tap. These samples were analyzed by histological, cytological, flow cytometric, cytogenetic, and molecular assessments. The patient died of a multiple organ dysfunction syndrome 2 weeks after his third relapse. The biopsy revealed a diffuse proliferation made up of two types of tumor cells: centroblasts (Bcl-6-positive) and immature cells (terminal deoxynucleotidyl transferase-positive). Flow cytometric analysis confirmed the immature phenotype, with an expression of terminal deoxynucleotidyl transferase, combined with a loss of membrane immunoglobulins. The cytogenetic analysis performed on the ascites revealed a clonal evolution characterized by a t(8;22)(q24;q11) MYC+ translocation not previously detected in follicular lymphoma. Fluorescence in situ hybridization confirmed the double rearrangement of the BCL2 and MYC genes. Polymerase chain reactions and sequencing were used to study the clonal relationship between follicular lymphoma and the secondary tumors. The IGVH gene rearrangement revealed a unique clonal rearrangement involving an IGVH4–59 subset in all three specimens. Conclusion These findings suggest a clonal relationship between the two types of lymphoma cells. Furthermore, they support the transformation of an acute follicular lymphoma into a composite lymphoma combining a high-grade B-cell lymphoma and a lymphoblastic neoplasm expressing terminal deoxynucleotidyl transferase. This case report highlights the possible transformation of follicular lymphoma into a highly aggressive and immature proliferation.
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Affiliation(s)
| | | | - Clémentine Legrand
- Laboratory of Hematology and Oncohematology, CHU de Grenoble, Grenoble, France
| | - Tatiana Raskovalova
- Laboratory of Hematology and Oncohematology, CHU de Grenoble, Grenoble, France
| | - Gautier Szymanski
- Laboratory of Hematology and Oncohematology, CHU de Grenoble, Grenoble, France
| | - Claire Vettier
- Laboratory of Hematology and Oncohematology, CHU de Grenoble, Grenoble, France
| | - Christine Lefebvre
- Laboratory of Hematology and Oncohematology, CHU de Grenoble, Grenoble, France
| | | | - Anne McLeer
- Department of Pathology, CHU de Grenoble, Grenoble, France
| | | | - Rémy Gressin
- Department of Hematology, CHU de Grenoble, Grenoble, France
| | - Hervé Sartelet
- Department of Pathology, CHU de Grenoble, Grenoble, France.
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13
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Noble J, Maniere L, Pernollet M, Jacob MC, Germi R, Chevallier E, Rostaing L. Baseline anti-CMV cellular immunity is similar between patients with a kidney transplant or receiving hemodialysis. Transpl Int 2020; 33:961-962. [PMID: 32311202 DOI: 10.1111/tri.13620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Johan Noble
- Nephrology, Hemodialysis, Apheresis, and Kidney Transplantation Department, University Hospital of Grenoble-Alpes, Grenoble, France
| | - Louis Maniere
- Nephrology, Hemodialysis, Apheresis, and Kidney Transplantation Department, University Hospital of Grenoble-Alpes, Grenoble, France
| | - Martine Pernollet
- Immunology Department, University Hospital of Grenoble-Alpes, Grenoble, France
| | | | - Raphaëlle Germi
- Virology Department, University Hospital of Grenoble-Alpes, Grenoble, France.,University Grenoble-Alpes, Grenoble, France
| | - Eloi Chevallier
- Nephrology, Hemodialysis, Apheresis, and Kidney Transplantation Department, University Hospital of Grenoble-Alpes, Grenoble, France
| | - Lionel Rostaing
- Nephrology, Hemodialysis, Apheresis, and Kidney Transplantation Department, University Hospital of Grenoble-Alpes, Grenoble, France.,University Grenoble-Alpes, Grenoble, France
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14
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Mondet J, Laurin D, Lo Presti C, Jacob MC, Meunier M, Giraudon E, Lefebvre C, Berthier S, Leer AM, Park S, Mossuz P. Increased S100A8 expression in bone marrow plasma by monocytic cells from acute myeloid leukemia patients. Hematol Oncol 2020; 38:114-118. [PMID: 31904882 DOI: 10.1002/hon.2707] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 12/06/2019] [Accepted: 12/16/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Julie Mondet
- Institute for Advanced Biosciences, University Grenoble Alpes /INSERM U1209/CNRS 5309, Grenoble, France.,Molecular Pathology Laboratory, Centre Hospitalier Grenoble Alpes, Grenoble, France
| | - David Laurin
- Institute for Advanced Biosciences, University Grenoble Alpes /INSERM U1209/CNRS 5309, Grenoble, France.,Etablissement Français du Sang, La Tronche, France
| | - Caroline Lo Presti
- Institute for Advanced Biosciences, University Grenoble Alpes /INSERM U1209/CNRS 5309, Grenoble, France
| | | | - Mathieu Meunier
- Institute for Advanced Biosciences, University Grenoble Alpes /INSERM U1209/CNRS 5309, Grenoble, France.,Department of Clinical Hematology, Centre Hospitalier Grenoble Alpes, Grenoble, France
| | - Emmanuelle Giraudon
- Department of Biological Hematology, Centre Hospitalier Grenoble Alpes, Grenoble, France
| | - Christine Lefebvre
- Oncohematology Laboratory, Centre Hospitalier Grenoble Alpes, Grenoble, France
| | - Sylvie Berthier
- Flow Cytometry Platform, Centre Hospitalier Grenoble Alpes, Grenoble, France
| | - Anne Mc Leer
- Institute for Advanced Biosciences, University Grenoble Alpes /INSERM U1209/CNRS 5309, Grenoble, France.,Molecular Pathology Laboratory, Centre Hospitalier Grenoble Alpes, Grenoble, France
| | - Sophie Park
- Institute for Advanced Biosciences, University Grenoble Alpes /INSERM U1209/CNRS 5309, Grenoble, France.,Department of Clinical Hematology, Centre Hospitalier Grenoble Alpes, Grenoble, France
| | - Pascal Mossuz
- Institute for Advanced Biosciences, University Grenoble Alpes /INSERM U1209/CNRS 5309, Grenoble, France.,Department of Biological Hematology, Centre Hospitalier Grenoble Alpes, Grenoble, France
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15
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Solly F, Angelot-Delettre F, Ticchioni M, Geneviève F, Rambaud H, Baseggio L, Plesa A, Debliquis A, Garnache-Ottou F, Roggy A, Campos L, Aanei C, Rosenthal-Allieri A, Georget MT, Lachot S, Jacob MC, Robillard N, Wuilleme S, Andre-Kerneis E, Cornet E, Salaun V, Bennami H, Lhoumeau AC, Arnoulet C, Jacqmin H, Neyman N, Latger-Cannard V, Massin F, Lainey E, Le Garff-Tavernier M, Costopoulos M, Roussel M, Mayeur-Rousse C, Eischen A, Raggeneau V, Derrieux C, Maurer M, Asnafi V, Trinquand A, Brouzes C, Lhermitte L. Standardization of Flow Cytometric Immunophenotyping for Hematological Malignancies: The FranceFlow Group Experience. Cytometry A 2019; 95:1008-1018. [PMID: 31364809 DOI: 10.1002/cyto.a.23844] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 06/04/2019] [Accepted: 06/05/2019] [Indexed: 01/25/2023]
Abstract
Flow cytometry is broadly used for the identification, characterization, and monitoring of hematological malignancies. However, the use of clinical flow cytometry is restricted by its lack of reproducibility across multiple centers. Since 2006, the EuroFlow consortium has been developing a standardized procedure detailing the whole process from instrument settings to data analysis. The FranceFlow group was created in 2010 with the intention to educate participating centers in France about the standardized instrument setting protocol (SOP) developed by the EuroFlow consortium and to organise several rounds of quality controls (QCs) in order to evaluate the feasibility of its application and its results. Here, we report the 5 year experience of the FranceFlow group and the results of the seven QCs of 23 instruments, involving up to 19 centers, in France and in Belgium. The FranceFlow group demonstrates that both the distribution and applicability of the SOP have been successful. Intercenter reproducibility was evaluated using both normal and pathological blood samples. Coefficients of variation (CVs) across the centers were <7% for the percentages of cell subsets and <30% for the median fluorescence intensities (MFIs) of the markers tested. Intracenter reproducibility provided similar results with CVs of <3% for the percentages of the majority of cell subsets, and CVs of <20% for the MFI values for the majority of markers. Altogether, the FranceFlow group show that the 19 participating labs might be considered as one unique laboratory with 23 identical flow cytometers able to reproduce identical results. Therefore, SOP significantly improves reproducibility of clinical flow in hematology and opens new avenues by providing a robust companion diagnostic tool for clinical trials in hematology. © 2019 International Society for Advancement of Cytometry.
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Affiliation(s)
- Françoise Solly
- CHU de St Etienne, Laboratoire d'hématologie, Saint-Etienne, France.,CHU Vaudois-Lausanne, Laboratoire d'hématologie, Lausanne, Switzerland
| | - Fanny Angelot-Delettre
- Etablissement Francais du Sang Bourgogne Franche-Comte, laboratoire d'hématologie, F-25000, Besançon, France.,Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000, Besançon, France
| | | | - Franck Geneviève
- CHU Angers, Laboratoire d'Hématologie Fédération Hospitalo-Universitaire GOAL, Grand Ouest Against Leukemia, Angers, France
| | - Hubert Rambaud
- CHU Angers, Laboratoire d'Hématologie Fédération Hospitalo-Universitaire GOAL, Grand Ouest Against Leukemia, Angers, France
| | - Lucile Baseggio
- Centre Hospitalier Lyon Sud Hospices civils de Lyon, Laboratoire d'hématologie, Lyon, France
| | - Adriana Plesa
- Centre Hospitalier Lyon Sud Hospices civils de Lyon, Laboratoire d'hématologie, Lyon, France
| | - Agathe Debliquis
- Groupe Hospitalier de la région Mulhouse sud Alsace, Laboratoire d'Hématologie, Mulhouse, France
| | - Francine Garnache-Ottou
- Etablissement Francais du Sang Bourgogne Franche-Comte, laboratoire d'hématologie, F-25000, Besançon, France.,Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000, Besançon, France
| | - Anne Roggy
- Etablissement Francais du Sang Bourgogne Franche-Comte, laboratoire d'hématologie, F-25000, Besançon, France
| | - Lydia Campos
- CHU de St Etienne, Laboratoire d'hématologie, Saint-Etienne, France
| | - Carmen Aanei
- CHU de St Etienne, Laboratoire d'hématologie, Saint-Etienne, France
| | | | | | | | | | | | | | | | - Edouard Cornet
- CHU Caen, Laboratoire d'Hématologie; INSERM U1245, Group Biomarkers of lymphoma and solid Tumors Equipe MICAH, Caen, France
| | - Véronique Salaun
- Centre Hospitalier Universitaire de Caen, Laboratoire d'hématologie, Caen, France
| | - Hind Bennami
- Institut Curie, Laboratoire d'hématologie, Saint-Cloud, France
| | | | - Christine Arnoulet
- Institut Paoli-Calmettes, Département de Biologie du cancer, Institut Paoli-Calmettes, Département de Biologie du cancer, Marseille, France
| | - Hugues Jacqmin
- CHU UCL Namur, Laboratoire d'Hématologie, Namur, Belgium
| | - Nicolas Neyman
- CHU UCL Namur, Laboratoire d'Hématologie, Namur, Belgium
| | | | - Fredéric Massin
- Centre Hospitalier Universitaire de Nancy, Plateforme de cytometrie en flux, Nancy, France
| | - Elodie Lainey
- Hôpital Robert Debré- APHP, Service d'Hématologie Biologique, Hôpital Robert Debré- APHP, UMRS_1131- Institut Universitaire d'Hématologie, Paris, France
| | - Magali Le Garff-Tavernier
- Groupe Hospitalier Pitié-Salpêtrière, UF Phénotypage des Hémopathies, Centre d'Ecologie Cellulaire, Service d'hématologie Biologique, Paris, France
| | - Myrto Costopoulos
- Groupe Hospitalier Pitié-Salpêtrière, UF Phénotypage des Hémopathies, Centre d'Ecologie Cellulaire, Service d'hématologie Biologique, Paris, France.,INSERM U1138, Programmed Cell Death and Physiopathology of Tumor Cells Centre de recherche des cordeliers, Paris, France
| | | | | | - Alice Eischen
- CHU Strasbourg, Laboratoire d'hématologie, Strasbourg, France
| | - Victoria Raggeneau
- CH Versailles, Service de biologie médicale, Unité d'hématologie et de cytogénétique onco hématologique, Versailles, France
| | - Coralie Derrieux
- Grand Hôpital de l'Est Francilien, Laboratoire d'Hématologie, Meaux, France
| | - Maxime Maurer
- Hôpitaux Civils de Colmar, Laboratoire d'Hématologie, Colmar, France
| | - Vahid Asnafi
- Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades (INEM), Institut National de recherche Médicale (INSERM) U1151, Paris, France.,Hôpital Necker Enfants-Malades, Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Amélie Trinquand
- Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades (INEM), Institut National de recherche Médicale (INSERM) U1151, Paris, France.,Hôpital Necker Enfants-Malades, Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Chantal Brouzes
- Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades (INEM), Institut National de recherche Médicale (INSERM) U1151, Paris, France.,Hôpital Necker Enfants-Malades, Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Ludovic Lhermitte
- Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades (INEM), Institut National de recherche Médicale (INSERM) U1151, Paris, France.,Hôpital Necker Enfants-Malades, Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
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16
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Raskovalova T, Berger MG, Jacob MC, Park S, Campos L, Aanei CM, Kasprzak J, Pereira B, Labarère J, Cesbron JY, Veyrat-Masson R. Flow cytometric analysis of neutrophil myeloperoxidase expression in peripheral blood for ruling out myelodysplastic syndromes: a diagnostic accuracy study. Haematologica 2019; 104:2382-2390. [PMID: 31004030 PMCID: PMC6959174 DOI: 10.3324/haematol.2018.202275] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 04/18/2019] [Indexed: 11/20/2022] Open
Abstract
Suspicion of myelodysplastic syndromes (MDS) is one of the commonest reasons for bone marrow aspirate in elderly patients presenting with persistent peripheral blood (PB) cytopenia of unclear etiology. A PB assay that accurately rules out MDS would have major benefits. The diagnostic accuracy of the intra-individual robust coefficient of variation (RCV) for neutrophil myeloperoxidase (MPO) expression measured by flow cytometric analysis in PB was evaluated in a retrospective derivation study (44 MDS cases and 44 controls) and a prospective validation study (68 consecutive patients with suspected MDS). Compared with controls, MDS cases had higher median RCV values for neutrophil MPO expression (40.2% vs. 30.9%; P<0.001). The area under the receiver operating characteristic curve estimates were 0.94 [95% confidence interval (CI): 0.86-0.97] and 0.87 (95%CI: 0.76-0.94) in the derivation and validation studies, respectively. A RCV lower than 30% ruled out MDS with 100% sensitivity (95%CI: 78-100%) and 100% negative predictive value (95%CI: 83-100%) in the prospective validation study. Neutrophil MPO expression measured by flow cytometric analysis in PB might obviate the need for invasive bone marrow aspirate and biopsy for up to 29% of patients with suspected MDS.
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Affiliation(s)
- Tatiana Raskovalova
- Laboratoire d'Immunologie, Grenoble University Hospital, Université Grenoble Alpes, F-38043 Grenoble
| | - Marc G Berger
- Service d'Hématologie Biologique, Hopital Estaing, Centre Hospitalier Universitaire de Clermont-Ferrand, F-63003 Clermont-Ferrand.,Université Clermont Auvergne, EA 7453 CHELTER, F-63000 Clermont-Ferrand
| | - Marie-Christine Jacob
- Laboratoire d'Immunologie, Grenoble University Hospital, Université Grenoble Alpes, F-38043 Grenoble
| | - Sophie Park
- Clinique Universitaire d'Hématologie, Grenoble University Hospital, F-38043 Grenoble.,Institute for Advanced Biosciences (IAB), INSERM U1209, CNRS UMR 5309, Université Grenoble Alpes, Grenoble
| | - Lydia Campos
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Saint-Etienne, F-42055, Saint-Etienne
| | - Carmen Mariana Aanei
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Saint-Etienne, F-42055, Saint-Etienne
| | - Julie Kasprzak
- Service d'Hématologie Biologique, Hopital Estaing, Centre Hospitalier Universitaire de Clermont-Ferrand, F-63003 Clermont-Ferrand
| | - Bruno Pereira
- Biostatistics Unit, Direction de la Recherche Clinique (DRCI), Centre Hospitalier Universitaire de Clermont-Ferrand, F-63003 Clermont-Ferrand
| | - José Labarère
- Quality of Care Unit, INSERM CIC 1406, Grenoble University Hospital, F-38043 Grenoble and.,TIMC-IMAG, CNRS UMR 5525, Université Grenoble Alpes, F-38043 Grenoble, France
| | - Jean-Yves Cesbron
- Laboratoire d'Immunologie, Grenoble University Hospital, Université Grenoble Alpes, F-38043 Grenoble.,TIMC-IMAG, CNRS UMR 5525, Université Grenoble Alpes, F-38043 Grenoble, France
| | - Richard Veyrat-Masson
- Service d'Hématologie Biologique, Hopital Estaing, Centre Hospitalier Universitaire de Clermont-Ferrand, F-63003 Clermont-Ferrand
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17
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Aanei CM, Jacob MC, Veyrat-Masson R, Picot T, Rosenthal-Allieri MA, Lhoumeau AC, Ticchioni M, Dumezy F, Campos Catafal L. Database-guided Flow-cytometry for Evaluation of Bone Marrow Myeloid Cell Maturation. J Vis Exp 2018. [PMID: 30451229 DOI: 10.3791/57867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
A working group initiated within the French Cytometry Association (AFC) was developed in order to harmonize the application of multiparameter flow cytometry (MFC) for myeloid disease diagnosis in France. The protocol presented here was agreed-upon and applied between September 2013 and November 2015 in six French diagnostic laboratories (University Hospitals of Saint-Etienne, Grenoble, Clermont-Ferrand, Nice, and Lille and Institut Paoli-Calmettes in Marseille) and allowed the standardization of bone marrow sample preparation and data acquisition. Three maturation databases were developed for neutrophil, monocytic, and erythroid lineages with bone marrow from "healthy" donor individuals (individuals without any evidence of a hematopoietic disease). A robust method of analysis for each myeloid lineage should be applicable for routine diagnostic use. New cases can be analyzed in the same manner and compared against the usual databases. Thus, quantitative and qualitative phenotypic abnormalities can be identified and those above 2SD compared with data of normal bone marrow samples should be considered indicative of pathology. The major limitation is the higher variability between the data achieved using the monoclonal antibodies obtained with the methods based on hybridoma technologies and currently used in clinical diagnosis. Setting criteria for technical validation of the data acquired may help improve the utility of MFC for MDS diagnostics. The establishment of these criteria requires analysis against a database. The reduction of investigator subjectivity in data analysis is an important advantage of this method.
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Affiliation(s)
| | | | | | - Tiphanie Picot
- Department of Hematology, University Hospital of Saint-Etienne
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18
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Park S, Kosmider O, Maloisel F, Drenou B, Chapuis N, Lefebvre T, Karim Z, Puy H, Alary AS, Ducamp S, Verdier F, Bouilloux C, Rousseau A, Jacob MC, Debliquis A, Charpentier A, Gyan E, Anglaret B, Leyronnas C, Corm S, Slama B, Cheze S, Laribi K, Amé S, Rose C, Lachenal F, Toma A, Pica GM, Carre M, Garban F, Mariette C, Cahn JY, Meunier M, Herault O, Fenaux P, Wagner-Ballon O, Bardet V, Dreyfus F, Fontenay M. Dyserythropoiesis evaluated by the RED score and hepcidin:ferritin ratio predicts response to erythropoietin in lower-risk myelodysplastic syndromes. Haematologica 2018; 104:497-504. [PMID: 30287621 PMCID: PMC6395339 DOI: 10.3324/haematol.2018.203158] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 10/02/2018] [Indexed: 12/29/2022] Open
Abstract
Erythropoiesis-stimulating agents are generally the first line of treatment of anemia in patients with lower-risk myelodysplastic syndrome. We prospectively investigated the predictive value of somatic mutations, and biomarkers of ineffective erythropoiesis including the flow cytometry RED score, serum growth-differentiation factor-15, and hepcidin levels. Inclusion criteria were no prior treatment with erythropoiesis-stimulating agents, low- or intermediate-1-risk myelodysplastic syndrome according to the International Prognostic Scoring System, and a hemoglobin level <10 g/dL. Patients could be red blood cell transfusion-dependent or not and were given epoetin zeta 40 000 IU/week. Serum erythropoietin level, iron parameters, hepcidin, flow cytometry Ogata and RED scores, and growth-differentiation factor-15 levels were determined at baseline, and molecular analysis by next-generation sequencing was also conducted. Erythroid response (defined according to the International Working Group 2006 criteria) was assessed at week 12. Seventy patients, with a median age of 78 years, were included in the study. There were 22 patients with refractory cytopenia with multilineage dysplasia, 19 with refractory cytopenia with unilineage dysplasia, 14 with refractory anemia with ring sideroblasts, four with refractory anemia with excess blasts-1, six with chronic myelomonocytic leukemia, two with del5q-and three with unclassifiable myelodysplastic syndrome. According to the revised International Prognostic Scoring System, 13 had very low risk, 47 had low risk, nine intermediate risk and one had high-risk disease. Twenty patients were transfusion dependent. Forty-eight percent had an erythroid response and the median duration of the response was 26 months. At baseline, non-responders had significantly higher RED scores and lower hepcidin:ferritin ratios. In multivariate analysis, only a RED score >4 (P=0.05) and a hepcidin:ferritin ratio <9 (P=0.02) were statistically significantly associated with worse erythroid response. The median response duration was shorter in patients with growth-differentiation factor-15 >2000 pg/mL and a hepcidin:ferritin ratio <9 (P=0.0008 and P=0.01, respectively). In multivariate analysis, both variables were associated with shorter response duration. Erythroid response to epoetin zeta was similar to that obtained with other erythropoiesis-stimulating agents and was correlated with higher baseline hepcidin:ferritin ratio and lower RED score. ClinicalTrials.gov registration: NCT 03598582.
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Affiliation(s)
- Sophie Park
- Department of Hematology, CHU Grenoble-Alpes, Grenoble .,Institute for Advanced Biosciences, INSERM U1209, CNRS UMR 5309, Grenoble
| | - Olivier Kosmider
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service d'Hématologie Biologique, Hôpitaux Universitaires Paris Centre, Institut Cochin, Université Paris Descartes
| | | | - Bernard Drenou
- Department of Hematology, Hôpital Emile Muller, CH de Mulhouse
| | - Nicolas Chapuis
- INSERM UMR1149, CNRS 8252 - Centre de Recherche sur l'Inflammation (CRI) Equipe "Hème, Fer et Pathologies Inflammatoires", Labex GREX, Centre Français des Porphyries - Hôpital Louis Mourier HUPNVS, Paris
| | - Thibaud Lefebvre
- Institut Cochin, INSERM U1016, CNRS UMR 8104, Paris Descartes University
| | - Zoubida Karim
- INSERM UMR1149, CNRS 8252 - Centre de Recherche sur l'Inflammation (CRI) Equipe "Hème, Fer et Pathologies Inflammatoires", Labex GREX, Centre Français des Porphyries - Hôpital Louis Mourier HUPNVS, Paris
| | - Hervé Puy
- INSERM UMR1149, CNRS 8252 - Centre de Recherche sur l'Inflammation (CRI) Equipe "Hème, Fer et Pathologies Inflammatoires", Labex GREX, Centre Français des Porphyries - Hôpital Louis Mourier HUPNVS, Paris
| | - Anne Sophie Alary
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service d'Hématologie Biologique, Hôpitaux Universitaires Paris Centre, Institut Cochin, Université Paris Descartes
| | - Sarah Ducamp
- Institut Cochin, INSERM U1016, CNRS UMR 8104, Paris Descartes University
| | - Frédérique Verdier
- Institut Cochin, INSERM U1016, CNRS UMR 8104, Paris Descartes University
| | - Cécile Bouilloux
- Department of Hematology, CHU Grenoble-Alpes, Grenoble.,Institute for Advanced Biosciences, INSERM U1209, CNRS UMR 5309, Grenoble
| | - Alice Rousseau
- Institut Cochin, INSERM U1016, CNRS UMR 8104, Paris Descartes University
| | | | | | | | | | | | | | | | | | | | | | - Shanti Amé
- Department of Hematology, Hôpital Civil, CHU Strasbourg
| | - Christian Rose
- Department of Hematology, Hôpital Saint Vincent de Paul, Lille
| | | | - Andrea Toma
- Department of Hematology, Hôpital Universitaire Henri Mondor, AP-HP, Université Paris 12, Créteil
| | | | - Martin Carre
- Department of Hematology, CHU Grenoble-Alpes, Grenoble.,Institute for Advanced Biosciences, INSERM U1209, CNRS UMR 5309, Grenoble
| | - Frédéric Garban
- Department of Hematology, CHU Grenoble-Alpes, Grenoble.,Institute for Advanced Biosciences, INSERM U1209, CNRS UMR 5309, Grenoble
| | - Clara Mariette
- Department of Hematology, CHU Grenoble-Alpes, Grenoble.,Institute for Advanced Biosciences, INSERM U1209, CNRS UMR 5309, Grenoble
| | - Jean-Yves Cahn
- Department of Hematology, CHU Grenoble-Alpes, Grenoble.,Institute for Advanced Biosciences, INSERM U1209, CNRS UMR 5309, Grenoble
| | - Mathieu Meunier
- Department of Hematology, CHU Grenoble-Alpes, Grenoble.,Institute for Advanced Biosciences, INSERM U1209, CNRS UMR 5309, Grenoble
| | | | - Pierre Fenaux
- Department of Hematology, Saint Louis Hospital, AP-HP, Université Paris Diderot
| | - Orianne Wagner-Ballon
- Département d'Hématologie et Immunologie Biologiques, Hôpital Universitaire Henri Mondor, Creteil
| | - Valerie Bardet
- Service d'Hématologie Immunologie Transfusion, Hôpitaux Universitaires Paris Ile de France-Ouest, AP-HP
| | | | - Michaela Fontenay
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service d'Hématologie Biologique, Hôpitaux Universitaires Paris Centre, Institut Cochin, Université Paris Descartes
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Pont J, Souvignet A, Campos L, Plesa A, Bulabois B, Pernollet M, Raskovalova T, Dumestre-Perard C, Cesbron JY, Jacob MC. Accurate quantification of fourteen normal bone marrow cell subsets in infants to the elderly by flow cytometry. Cytometry 2018; 94:627-636. [DOI: 10.1002/cyto.b.21643] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 05/16/2018] [Accepted: 05/23/2018] [Indexed: 01/28/2023]
Affiliation(s)
- Julie Pont
- Department of Immunology; Grenoble-Alpes University Hospital (CHUGA); Grenoble F-38700 France
| | - Alice Souvignet
- Department of Hematology; Annecy Genevois Hospital; Metz -Tessy, F-74370 France
| | - Lydia Campos
- Department of Hematology; HU Saint-Etienne University Hospital; Saint Priest en Jarez F-42270 France
| | - Adriana Plesa
- Department of Hematology; Hospices Civils de Lyon; Pierre-Bénite F-69495 France
| | - Bénédicte Bulabois
- Department of Hematology; Grenoble-Alpes University Hospital (CHUGA) Grenoble; F-38700 France
| | - Martine Pernollet
- Department of Immunology; Grenoble-Alpes University Hospital (CHUGA); Grenoble F-38700 France
| | - Tatiana Raskovalova
- Department of Immunology; Grenoble-Alpes University Hospital (CHUGA); Grenoble F-38700 France
| | - Chantal Dumestre-Perard
- Department of Immunology; Grenoble-Alpes University Hospital (CHUGA); Grenoble F-38700 France
- INSERM U823; CRI/ Institut Albert Bonniot; La Tronche F-38700 France
| | - Jean-Yves Cesbron
- Department of Immunology; Grenoble-Alpes University Hospital (CHUGA); Grenoble F-38700 France
| | - Marie-Christine Jacob
- Department of Immunology; Grenoble-Alpes University Hospital (CHUGA); Grenoble F-38700 France
- INSERM U1209, CNRS UMR 5309; Institute for Advanced Biosciences, Université Grenoble Alpes, Institute for Advanced Biosciences; Grenoble France
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20
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Clavarino G, Delouche N, Vettier C, Laurin D, Pernollet M, Raskovalova T, Cesbron JY, Dumestre-Pérard C, Jacob MC. Novel Strategy for Phenotypic Characterization of Human B Lymphocytes from Precursors to Effector Cells by Flow Cytometry. PLoS One 2016; 11:e0162209. [PMID: 27657694 PMCID: PMC5033467 DOI: 10.1371/journal.pone.0162209] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 08/18/2016] [Indexed: 11/19/2022] Open
Abstract
A precise identification and phenotypic characterization of human B-cell subsets is of crucial importance in both basic research and medicine. In the literature, flow cytometry studies for the phenotypic characterization of B-lymphocytes are mainly focused on the description of a particular cell stage, or of specific cell stages observed in a single type of sample. In the present work, we propose a backbone of 6 antibodies (CD38, CD27, CD10, CD19, CD5 and CD45) and an efficient gating strategy to identify, in a single analysis tube, a large number of B-cell subsets covering the whole B-cell differentiation from precursors to memory and plasma cells. Furthermore, by adding two antibodies in an 8-color combination, our approach allows the analysis of the modulation of any cell surface marker of interest along B-cell differentiation. We thus developed a panel of seven 8-colour antibody combinations to phenotypically characterize B-cell subpopulations in bone marrow, peripheral blood, lymph node and cord blood samples. Beyond qualitative information provided by biparametric representations, we also quantified antigen expression on each of the identified B-cell subsets and we proposed a series of informative curves showing the modulation of seventeen cell surface markers along B-cell differentiation. Our approach by flow cytometry provides an efficient tool to obtain quantitative data on B-cell surface markers expression with a relative easy-to-handle technique that can be applied in routine explorations.
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Affiliation(s)
- Giovanna Clavarino
- Laboratoire d'Immunologie, Département d'Hématologie, Oncogénétique et Immunologie, Pôle de Biologie, Grenoble University Hospital, Grenoble, France
- BNI, TIMC-IMAG, UMR 5525 CNRS, Grenoble, France
- Université Grenoble-Alpes, Grenoble, France
| | - Noémie Delouche
- Laboratoire d'Immunologie, Département d'Hématologie, Oncogénétique et Immunologie, Pôle de Biologie, Grenoble University Hospital, Grenoble, France
| | - Claire Vettier
- Laboratoire d'Hématologie, Département d'Hématologie, Oncogénétique et Immunologie, Pôle de Biologie, Grenoble University Hospital, Grenoble, France
| | - David Laurin
- TheREx, TIMC-IMAG, UMR 5525 CNRS, Grenoble, France
- Etablissement Français du Sang Rhônes-Alpes Auvergne, La Tronche, France
- Université Grenoble-Alpes, Grenoble, France
| | - Martine Pernollet
- Laboratoire d'Immunologie, Département d'Hématologie, Oncogénétique et Immunologie, Pôle de Biologie, Grenoble University Hospital, Grenoble, France
| | - Tatiana Raskovalova
- Laboratoire d'Immunologie, Département d'Hématologie, Oncogénétique et Immunologie, Pôle de Biologie, Grenoble University Hospital, Grenoble, France
| | - Jean-Yves Cesbron
- Laboratoire d'Immunologie, Département d'Hématologie, Oncogénétique et Immunologie, Pôle de Biologie, Grenoble University Hospital, Grenoble, France
- BNI, TIMC-IMAG, UMR 5525 CNRS, Grenoble, France
- Université Grenoble-Alpes, Grenoble, France
| | - Chantal Dumestre-Pérard
- Laboratoire d'Immunologie, Département d'Hématologie, Oncogénétique et Immunologie, Pôle de Biologie, Grenoble University Hospital, Grenoble, France
- BNI, TIMC-IMAG, UMR 5525 CNRS, Grenoble, France
- Université Grenoble-Alpes, Grenoble, France
| | - Marie-Christine Jacob
- Laboratoire d'Immunologie, Département d'Hématologie, Oncogénétique et Immunologie, Pôle de Biologie, Grenoble University Hospital, Grenoble, France
- Université Grenoble-Alpes, Grenoble, France
- CNRS UMR 5309 and INSERM U1209, Institut Albert Bonniot, Grenoble, France
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21
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Aspord C, Bruder Costa J, Jacob MC, Dufeu-Duchesne T, Bertucci I, Pouget N, Brevot-Lutton O, Zoulim F, Bourliere M, Plumas J, Leroy V. Remodeling of B-Cell Subsets in Blood during Pegylated IFNα-2a Therapy in Patients with Chronic Hepatitis B Infection. PLoS One 2016; 11:e0156200. [PMID: 27281019 PMCID: PMC4900671 DOI: 10.1371/journal.pone.0156200] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 05/10/2016] [Indexed: 01/09/2023] Open
Abstract
The ultimate goal of pegylated interferon-alfa-2a (Peg-IFN-α) therapy in chronic hepatitis B (CHB) infection is HBsAg seroconversion. Even though B cells are major mediators of a positive clinical outcome, their modulation during Peg-IFN-α therapy has not yet been described. We investigated here the effects of Peg-IFN-α on eight circulating B-cell subsets thanks to an original multi-gating approach based on CD19, CD27, IgD, CD10, and CD38 markers in patients with CHB treated with nucleos(t)ide analog alone or in combination with Peg-IFN-α. These dynamic changes were analyzed during the 48-weeks of Peg-IFN-α therapy and up to 2 years after the cessation of treatment. The CD19+CD27-IgD+CD10+CD38high transitional B cells and the CD19+CD27+IgD-CD10-CD38high plasmablasts continuously increased, whereas the CD19+CD27-IgD+CD10-CD38low naive, CD19+CD27+IgD+ natural memory, and CD19+CD27+IgD-CD10-CD38low post-germinal center B cells decreased during the course of Peg-IFNα treatment. Such modulations correlated with a sustained increase in sCD30 levels and the decrease in plasma HBsAg. However, no seroconversion occurred and all parameters returned to baseline after the stop of the treatment. Peg-IFN-α therapy mediates a remodeling of B-cell compartmentalization, without clinical relevance. Our study provides new insights into the immunomodulatory effects of Peg-IFN-α on circulating B-cells, and questioned the benefit of the add-on Peg-IFN-α treatment in CHB.
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Affiliation(s)
- Caroline Aspord
- University Joseph Fourier, Grenoble, F-38041, France; INSERM, U823, Immunobiology & Immunotherapy of Cancers, La Tronche, F-38706, France
- EFS Rhone-Alpes, R&D Laboratory, La Tronche, F-38701, France
- * E-mail:
| | - Juliana Bruder Costa
- University Joseph Fourier, Grenoble, F-38041, France; INSERM, U823, Immunobiology & Immunotherapy of Cancers, La Tronche, F-38706, France
- CHU Grenoble, Michallon Hospital, Hepato-gastroenterology unit, Grenoble, F-38043, France
| | - Marie-Christine Jacob
- University Joseph Fourier, Grenoble, F-38041, France; INSERM, U823, CRI/Institut Albert Bonniot, Grenoble, F-38000, France; Department of Immunology, CHU de Grenoble, Grenoble, F-38000, France
| | - Tania Dufeu-Duchesne
- CHU Grenoble, Michallon Hospital, Hepato-gastroenterology unit, Grenoble, F-38043, France
- University Joseph Fourier, Grenoble, F-38041, France; INSERM, U823, Analytic Immunology of chronic pathologies, La Tronche, F-38706, France
| | - Inga Bertucci
- ANRS (France REcherche Nord & sud Sida-hiv Hépatites: FRENSH), Paris, France
| | - Noelle Pouget
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP UMRS 1136), 75012, Paris, France
| | - Ophelie Brevot-Lutton
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP UMRS 1136), 75012, Paris, France
| | - Fabien Zoulim
- INSERM U1052—CNRS 5286, Cancer Research Center of Lyon (CRCL), Lyon, France
- Hepatology Department, Hospices Civils de Lyon, Lyon, France
- Université de Lyon, Lyon, France
| | - Marc Bourliere
- Hepato-gastroenterology department, Hospital Saint Joseph, Marseille, 13008, France
| | - Joel Plumas
- University Joseph Fourier, Grenoble, F-38041, France; INSERM, U823, Immunobiology & Immunotherapy of Cancers, La Tronche, F-38706, France
- EFS Rhone-Alpes, R&D Laboratory, La Tronche, F-38701, France
| | - Vincent Leroy
- CHU Grenoble, Michallon Hospital, Hepato-gastroenterology unit, Grenoble, F-38043, France
- University Joseph Fourier, Grenoble, F-38041, France; INSERM, U823, Analytic Immunology of chronic pathologies, La Tronche, F-38706, France
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22
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Jacob MC, Souvignet A, Pont J, Solly F, Mondet J, Kesr S, Pernollet M, Dumestre-Perard C, Campos L, Cesbron JY. One tube with eight antibodies for 14-part bone marrow leukocyte differential using flow cytometry. Cytometry B Clin Cytom 2016; 92:299-309. [PMID: 26990701 DOI: 10.1002/cyto.b.21369] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 02/16/2016] [Accepted: 03/10/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Bone marrow analysis by flow cytometry is part of the routine diagnosis of hematological disorders in medical laboratories. Differential leukocyte count and identification of abnormal cell subsets is currently performed through morphological examination on bone marrow smears by skilled cytologists. In this work, we propose a single 8-color tube for providing equivalent information, using flow cytometry. METHODS 99 bone marrow samples were classified into 2 groups, (i) 51 samples, obtained from either healthy donors (n = 4) or patients with various diseases at diagnosis or during remission that did not present a hematological malignancy (n = 47), and (ii) 48 pathological samples with quantitative and/or qualitative abnormalities. A panel of eight antibodies-CD3-FITC/CD10-PE/CD38-PerCP-Cy5.5/CD19-PECy7/CD36-APC/CD16-APC-H7/CD34-BV421/CD45-V500-was tested to identify the main cell subsets at different stages of maturation using a FACSCanto-II analyzer. RESULTS We first proposed a strategy of sequential gating leading to the identification of 14 leukocyte subsets, that is, erythroblasts, monocytes, B-lymphoid cells from hematogones to plasma-cells (5 subsets), T- and NK-cells, polymorphonuclear cells (neutrophils, eosinophils, and basophils), myeloblasts and other immature granular cells. This approach was validated by comparing flow cytometry and microscopic morphological examination, both in cases of normal and abnormal samples. Interestingly, cell identification, and numeration by flow cytometry was easy to perform and highly reproducible. CONCLUSION A very simple, rapid, and reproducible flow cytometric approach, using a combination of eight antibodies allows determination of the cellular composition of bone marrow with high precision. © 2016 International Clinical Cytometry Society.
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Affiliation(s)
- Marie-Christine Jacob
- Université Grenoble-Alpes, Grenoble, 38000, France.,CNRS UMR 5309 and INSERM, U1209, Institut Albert Bonniot, Grenoble, 38706, France.,Department of Immunology CHU Grenoble, La Tronche, F-38700, France
| | - Alice Souvignet
- Department of Immunology CHU Grenoble, La Tronche, F-38700, France
| | - Julie Pont
- Department of Hematology, CHU Grenoble, La Tronche, F-38700, France
| | - Françoise Solly
- Department of Hematology, CHU Saint Etienne, Saint Priest en Jarez, F-42270, France
| | - Julie Mondet
- Department of Hematology, CHU Grenoble, La Tronche, F-38700, France.,Therex, TIMC-IMAG, CNRS Université Joseph Fourier, La Tronche, F-38700, France
| | - Sanae Kesr
- Université Paris Diderot-CHU Saint Etienne, Saint Priest en Jarez, F-42270, France
| | | | | | - Lydia Campos
- Department of Hematology, CHU Saint Etienne, Saint Priest en Jarez, F-42270, France
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Fossat C, Roussel M, Arnoux I, Asnafi V, Brouzes C, Garnache-Ottou F, Jacob MC, Kuhlein E, Macintyre-Davi E, Plesa A, Robillard N, Tkaczuk J, Ifrah N, Dombret H, Béné MC, Baruchel A, Garand R. Methodological aspects of minimal residual disease assessment by flow cytometry in acute lymphoblastic leukemia: A French multicenter study. Cytometry B Clin Cytom 2014; 88:21-9. [PMID: 25363877 DOI: 10.1002/cyto.b.21195] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 08/24/2014] [Accepted: 09/29/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND Minimal residual disease (MRD) assessment provides a powerful prognostic factor for therapeutic stratification in acute lymphoblastic leukemia (ALL). Multiparameter flow cytometry (MFC) has the potential for a rapid and sensitive identification of high risk patients. Our group has previously published that MRD levels analyzed by clone specific Ig/TcR-QPCR and MFC were concordant at a sensitivity of 10(-4) . Here we report the MFC methodological aspects from this multi-center experience. METHODS MRD was assessed by MFC in 1030 follow-up samples from 265 pediatric and adult patients with de novo ALL treated in the FRALLE, EORTC, or GRALL clinical trials. MRD assessment as applied by the eight participating MFC laboratories is described in detail regarding cell preparation, leukemia-associated immunophenotype (LAIP) markers and data analysis. Samples were obtained from bone marrow (BM) and peripheral blood (PB). Immunostaining was performed after erythrocyte lysis or Ficoll enrichment. RESULTS This study confirms the applicability of MFC-based MRD assessment in 97% of patients with ALL at the 10(-4) cut-off. MRD values after Ficoll enrichment and erythrocyte lysis were found comparable. Higher MRD values were obtained in BM than in PB, especially for B-lineage ALL. CONCLUSIONS Measurement of MRD by MFC at the 10(-4) cut-off is applicable within a few hours for almost all patients and using a comparable analytical strategy allows for multicenter collaborative studies. The method can be introduced in a strategy aimed at defining the risk of failure of patients with childhood or adult ALL.
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Affiliation(s)
- Chantal Fossat
- Hematology Laboratory, Hôpital de la Timone, Marseille, France
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24
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Fossat C, Roussel M, Arnoux I, Asnafi V, Brouzes C, Garnache-Ottou F, Jacob MC, Kuhlein E, Macintyre-Davi E, Plesa A, Robillard N, Tkaczuk J, Ifrah N, Dombret H, Béné MC, Baruchel A, Garand R. Methodological aspects of minimal residual disease assessment by flow cytometry in acute lymphoblastic leukemia: A French multicenter study. Cytometry B Clin Cytom 2014:n/a-n/a. [PMID: 25270227 DOI: 10.1002/cytob.21195] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 08/24/2014] [Accepted: 09/29/2014] [Indexed: 11/05/2022]
Abstract
Background: Minimal residual disease (MRD) assessment provides a powerful prognostic factor for therapeutic stratification in acute lymphoblastic leukemia (ALL). Multiparameter flow cytometry (MFC) has the potential for a rapid and sensitive identification of high risk patients. Our group has previously published that MRD levels analyzed by clone specific Ig/TcR-QPCR and MFC were concordant at a sensitivity of 10-4 . Here we report the MFC methodological aspects from this multi-center experience. Methods: MRD was assessed by MFC in 1030 follow-up samples from 265 pediatric and adult patients with de novo ALL treated in the FRALLE, EORTC or GRALL clinical trials. MRD assessment as applied by the eight participating MFC laboratories is described in detail regarding cell preparation, leukemia-associated immunophenotype (LAIP) markers and data analysis. Samples were obtained from bone marrow (BM) and peripheral blood (PB). Immunostaining was performed after erythrocyte lysis or Ficoll enrichment. Results: This study confirms the applicability of MFC-based MRD assessment in 97% of patients with ALL at the 10-4 cut-off. MRD values after Ficoll enrichment and erythrocyte lysis were found comparable. Higher MRD values were obtained in BM than in PB, especially for B-lineage ALL. Conclusions: Measurement of MRD by MFC at the 10-4 cut-off is applicable within a few hours for almost all patients and using a comparable analytical strategy allows for multicenter collaborative studies. The method can be introduced in a strategy aimed at defining the risk of failure of patients with childhood or adult ALL. © 2014 Clinical Cytometry Society.
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Affiliation(s)
- C Fossat
- Hematology Laboratory, Hôpital de la Timone, Marseille, France
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25
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Demaret J, Walencik A, Jacob MC, Timsit JF, Venet F, Lepape A, Monneret G. Inter-laboratory assessment of flow cytometric monocyte HLA-DR expression in clinical samples. Cytometry B Clin Cytom 2012; 84:59-62. [PMID: 22987669 DOI: 10.1002/cyto.b.21043] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 07/31/2012] [Accepted: 08/20/2012] [Indexed: 12/16/2022]
Abstract
BACKGROUND Diminished expression of human leukocyte antigen DR on circulating monocytes (mHLA-DR) is a reliable indicator of immunosuppression in critically ill patients, predictive of both adverse outcome and septic complications. The objective of the present work was to test, in an inter-laboratory clinical study, a standardized protocol for mHLA-DR measurement by flow cytometry. METHODS mHLA-DR was assessed in fresh whole blood according to a standardized staining protocol. Cells were analyzed on different flow cytometers (FC500, Navios, FACS Canto II) in different laboratories (Lyon and Grenoble). Results were expressed as numbers of antibodies bound per cell (AB/C). RESULTS Correlations between results were excellent (Pearson and interclass correlation coefficients > 0.98). Coefficients of variations for intra-assay precision ranged from 1.9 to 3.2%. CONCLUSION The present report highlights the robustness of this standardized flow cytometric protocol for mHLA-DR measurement in multicentric clinical studies.
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Affiliation(s)
- Julie Demaret
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Laboratoire d'Immunologie, Lyon F-69003, France
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26
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Garban F, Carras S, Drillat P, Jacob MC, Fabre B, Callanan M, Courby S, Makowski C, Cahn JY, Gressin R. Extracorporeal photopheresis as a curative treatment strategy in non epidermotropic T-cell lymphoma and large granular lymphocyte leukemia. Ann Oncol 2012; 23:2386-2390. [PMID: 22422944 DOI: 10.1093/annonc/mds014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND To evaluate the efficacy of extracorporeal photopheresis (ECP) in noncutaneous T-cell lymphoma and large granular lymphocytes leukemia (LGL). PATIENTS AND METHODS We have treated 12 refractory/relapsed patients. Six peripheral T-cell lymphoma (PTCL), one T-lymphoblastic lymphoma and five LGL with blood involvement received six biweekly leukapheresis as induction phase, followed by one course a week for 4 weeks as consolidation and one course of maintenance per month for responders until progression/relapse or disappearance of the peripheral clone. RESULTS Six patients responded to phototherapy. Two PTCL and two LGL achieved a complete response (CR) and two other PTCL a partial response. The median duration of CR was 117 months (45-150 months) for these four patients. The peripheral clone followed by flow cytometry decreased in all six responders. Two patients with a complete disappearance of the peripheral clone have not relapsed. CONCLUSIONS As for cutaneous T-cell lymphoma, ECP therefore to be efficient for PTCL and LGL. Early decrease and disappearance of the peripheral clone were the indicators of clinical response and nonrelapse, respectively.
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Affiliation(s)
- F Garban
- Department of Haematology, Grenoble University Hospital, Grenoble
| | - S Carras
- Department of Haematology, Grenoble University Hospital, Grenoble
| | - P Drillat
- French National Blood Service, Grenoble Site, La Tronche
| | - M C Jacob
- Department of Immunology, Biology and Pathology Institute, Grenoble University Hospital, Grenoble; INSERM U823, Joseph Fourier University-Grenoble 1, Albert Bonniot Institute, Faculté de Médecine, La Tronche
| | - B Fabre
- Department of Pathology, Biology and Pathology Institute, Grenoble University Hospital, Grenoble
| | - M Callanan
- INSERM U823, Joseph Fourier University-Grenoble 1, Albert Bonniot Institute, Faculté de Médecine, La Tronche; Department of Onco-Hematological Genetic, Tumoral Molecular Genetic, Biology Institute, Grenoble University Hospital, Grenoble
| | - S Courby
- Department of Haematology, Grenoble University Hospital, Grenoble
| | - C Makowski
- French National Blood Service, Grenoble Site, La Tronche
| | - J Y Cahn
- Department of Haematology, Grenoble University Hospital, Grenoble; UMR CNRS 5525 THEREX, Joseph Fourier University Grenoble-UFR Médecine, La Tronche, France
| | - R Gressin
- Department of Haematology, Grenoble University Hospital, Grenoble; INSERM U823, Joseph Fourier University-Grenoble 1, Albert Bonniot Institute, Faculté de Médecine, La Tronche.
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27
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Salameire D, Solly F, Fabre B, Lefebvre C, Chauvet M, Gressin R, Corront B, Ciapa A, Pernollet M, Plumas J, Macintyre E, Callanan MB, Leroux D, Jacob MC. Accurate detection of the tumor clone in peripheral T-cell lymphoma biopsies by flow cytometric analysis of TCR-Vβ repertoire. Mod Pathol 2012; 25:1246-57. [PMID: 22627740 DOI: 10.1038/modpathol.2012.74] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Multiparametric flow cytometry has proven to be a powerful method for detection and immunophenotypic characterization of clonal subsets, particularly in lymphoproliferative disorders of the B-cell lineage. Although in theory promising, this approach has not been comparably fulfilled in mature T-cell malignancies. Specifically, the T-cell receptor-Vβ repertoire analysis in blood can provide strong evidence of clonality, particularly when a single expanded Vß family is detected. The purpose of this study was to determine the relevance of this approach when applied to biopsies, at the site of tumor involvement. To this end, 30 peripheral T-cell lymphoma and 94 control biopsies were prospectively studied. Vβ expansions were commonly detected within CD4+ or CD8+ T cells (97% of peripheral T-cell lymphoma and 54% of non-peripheral T-cell lymphoma cases); thus, not differentiating malignant from reactive processes. Interestingly, we demonstrated that using a standardized evaluation, the detection of a high Vβ expansion was closely associated with diagnosis of peripheral T-cell lymphoma, with remarkable specificity (98%) and sensitivity (90%). This approach also identified eight cases of peripheral T-cell lymphoma that were not detectable by other forms of immunophenotyping. Moreover, focusing Vβ expression analysis to T-cell subsets with aberrant immunophenotypes, we demonstrated that the T-cell clone might be heterogeneous with regard to surface CD7 or CD10 expression (4/11 cases), providing indication on 'phenotypic plasticity'. Finally, among the wide variety of Vβ families, the occurrence of a Vβ17 expansion in five cases was striking. To our knowledge, this is the first report demonstrating the power of T-cell receptor-Vβ repertoire analysis by flow cytometry in biopsies as a basis for peripheral T-cell lymphoma diagnosis and precise T-cell clone identification and characterization.
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Salameire D, Le Bris Y, Fabre B, Fauconnier J, Solly F, Pernollet M, Bonnefoix T, Leroux D, Plumas J, Jacob MC. Efficient characterization of the TCR repertoire in lymph nodes by flow cytometry. Cytometry A 2009; 75:743-51. [PMID: 19582873 DOI: 10.1002/cyto.a.20767] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Analysis of the T-cell receptor (TCR) repertoire by flow cytometry proved to be relevant for investigating T-cell diversity and detecting reactive cells in blood samples. We used this approach to characterize non-malignant T-lymphocytes in lymph nodes and give insights into their origin. The TCR repertoire of CD4+ and CD8+ T-cells from 81 lymph nodes was analyzed with a four-color flow cytometer using a wide panel of 25 anti-Vbeta monoclonal antibodies. Flow cytometry proved to be a useful and informative technique. We demonstrated a diversified TCR-Vbeta repertoire, and only low level expansions, in 53% of the samples. They involved nearly all Vbeta families, were more frequent in the CD8+ subset of older patients, but were not related to pathology. No evidence could be demonstrated in favor of stimulation by common antigens. Interestingly, the TCR-Vbeta repertoire proved to be very similar in lymph nodes and blood samples. Our results argue that in the cases studied, lymph node enlargement is mainly due to an increased homing of circulating T-cells. They also provide reference values for expression of 25 TCR-Vbeta in lymph nodes, which could serve as a basis for further applications in diagnosis of T-cell lymphoproliferative disorders.
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Affiliation(s)
- D Salameire
- Université Joseph Fourier Grenoble 1, F-38000, France
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29
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Garnache-Ottou F, Feuillard J, Ferrand C, Biichle S, Trimoreau F, Seilles E, Salaun V, Garand R, Lepelley P, Maynadié M, Kuhlein E, Deconinck E, Daliphard S, Chaperot L, Beseggio L, Foisseaud V, Macintyre E, Bene MC, Saas P, Jacob MC. Extended diagnostic criteria for plasmacytoid dendritic cell leukaemia. Br J Haematol 2009; 145:624-36. [PMID: 19388928 DOI: 10.1111/j.1365-2141.2009.07679.x] [Citation(s) in RCA: 127] [Impact Index Per Article: 8.5] [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
The diagnosis of plasmacytoid dendritic cell leukaemia (pDCL) is based on the immunophenotypic profile: CD4(+) CD56(+) lineage(neg) CD45RA(+)/RO(neg) CD11c(neg) CD116(low) CD123(+) CD34(neg) CD36(+) HLA-DR(+). Several studies have reported pDCL cases that do not express this exact profile or expressing some lineage antigens that could thus be misdiagnosed. This study aimed to validate pDCL-specific markers for diagnosis by flow-cytometry or quantitative reverse transcription polymerase chain reaction on bone marrow samples. Expression of markers previously found in normal pDC was analysed in 16 pDCL, four pDCL presenting an atypical phenotype (apDCL) and 113 non-pDC - lymphoid or myeloid - acute leukaemia. CD123 was expressed at significantly higher levels in pDCL and apDCL. BDCA-2 was expressed on 12/16 pDCL and on 2/4 apDCL, but was never detected in the 113 non-pDC acute leukaemia cases. BDCA-4 expression was found on 13/16 pDCL, but also in 12% of non-pDC acute leukaemia. High levels of LILRA4 and TCL1A transcripts distinguished pDCL and apDCL from all other acute leukaemia (except B-cell acute lymphoblastic leukaemia for TCL1A). We thus propose a diagnosis strategy, scoring first the CD4(+) CD56(+/-) MPO(neg) cCD3(neg) cCD79a(neg) CD11c(neg) profile and then the CD123(high), BDCA-2 and BDCA-4 expression. Atypical pDCL can be also identified this way and non-pDC acute leukaemia excluded: this scoring strategy is useful for diagnosing pDCL and apDCL.
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Affiliation(s)
- Francine Garnache-Ottou
- INSERM UMR645, Université of Franche-Comté, Etablissement Français du Sang Bourgogne Franche-Comté, 1 boulevard A. Fleming, Besançon, France.
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Dieterich K, Zouari R, Harbuz R, Vialard F, Martinez D, Bellayou H, Prisant N, Zoghmar A, Guichaoua MR, Koscinski I, Kharouf M, Noruzinia M, Nadifi S, Sefiani A, Lornage J, Zahi M, Viville S, Sèle B, Jouk PS, Jacob MC, Escalier D, Nikas Y, Hennebicq S, Lunardi J, Ray PF. The Aurora Kinase C c.144delC mutation causes meiosis I arrest in men and is frequent in the North African population. Hum Mol Genet 2009; 18:1301-9. [PMID: 19147683 DOI: 10.1093/hmg/ddp029] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Infertility concerns a minimum of 70 million couples worldwide. An important proportion of cases is believed to have a genetic component, yet few causal genes have been identified so far. In a previous study, we demonstrated that a homozygous mutation (c.144delC) in the Aurora Kinase C (AURKC) gene led to the production of large-headed polyploid multi-flagellar spermatozoa, a primary infertility phenotype mainly observed in North Africans. We now want to estimate the prevalence of the defect, to improve our understanding of AURKC physiopathology in spermatogenesis and assess its implication in oogenesis. A carrier frequency of 1/50 was established from individuals from the Maghrebian general population, comparable to that of Y-microdeletions, thus far the only known recurrent genetic event altering spermatogenesis. A total of 62 patients were genotyped, all who had a typical phenotype with close to 100% large-headed spermatozoa were homozygously mutated (n = 32), whereas no AURKC mutations were detected in the others. Two homozygous females were identified; both were fertile indicating that AURKC is not indispensible in oogenesis. Previous FISH results had showed a great chromosomal heterogeneity in these patient's spermatozoa. We demonstrate here by flow cytometry that all spermatozoa have in fact a homogeneous 4C DNA content and are thus all blocked before the first meiotic division. Our data thus indicate that a functional AURKC protein is necessary for male meiotic cytokinesis while its absence does not impair oogenesis.
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Affiliation(s)
- Klaus Dieterich
- Département de Génétique et Procréation, CHU de Grenoble, Grenoble Cedex 9, France
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Braham Jmili N, Nsaibia S, Jacob MC, Omri H, Laatiri MA, Yacoub S, Braham Y, Aouni M, Kortas M. Immunophenotypic analysis of bone marrow B lymphocyte precursors (hématogones) by flow cytometry. Clin Lab Sci 2009; 22:208-215. [PMID: 19967915] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The aims of this flow cytometry study were to quantify B lymphoid precursors known as hématogones across age and clinical conditions and to study the immunophenotypic profile of these benign immature B cells. A total of 406 consecutive marrow specimens were analyzed for hématogones using 4-color flow cytometry during a 19 month period (60% males and 40% females). The age range was 3 months to 89 years. Hématogones were present in 80% of the specimens. Morphologic analysis of the smears from each patient showed small numbers of hématogones (<13% of total cellularity). The B cell population was defined by CD19 + CD45 bright positivity, coexpression of other B lineage markers: CD20, CD22, CD10, CD29, CD38 and CD58 in addition to HLA-DR and CD34. In our study we found a significant decline in hématogones with increasing age but a broad range was found at all ages. Marrow from some adults contained relatively high numbers. Diagnosis in these patients included cytopenias, infections, and neoplastic diseases. Distinction of hématogones is critical for disease management particularly after therapy of paediatric B acute lymphoblastic leukaemia to monitor for minimal residual disease.
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Affiliation(s)
- N Braham Jmili
- Faculty of Pharmacy, University of Center, Monastir, Tunisia.
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Lefebvre C, Fabre B, Vettier C, Rabin L, Florin A, Wang J, Gressin R, Jacob MC, Callanan M, Leroux D. Composite splenic marginal zone lymphoma and mantle cell lymphoma arising from 2 independent B-cell clones. Hum Pathol 2006; 38:660-7. [PMID: 17134739 DOI: 10.1016/j.humpath.2006.08.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2006] [Accepted: 08/18/2006] [Indexed: 11/22/2022]
Abstract
We report the first case of composite lymphoma involving both mantle cell lymphoma (MCL) and splenic marginal zone lymphoma (SMZL) with circulating villous lymphocytes. Morphological, immunohistochemical, immunophenotyping, as well as detailed genetic studies (fluorescence in situ hybridization, IGVH gene sequencing), were performed and confirmed the existence of 2 independent, unrelated tumor clones. The MCL component expressed IgMD lambda, was CD5+, harbored a t(11;14)(q13;q32) involving CCND1, and showed an unmutated VH1-18 gene rearrangement. The SMZL component expressed IgMD kappa, was CD5-, showed a t(10;14)(q24;q32) and an unmutated VH3-7 gene rearrangement. Interestingly, this t(10;14) targeted the NFKB2 gene. Only a single other case of SMZL with t(10;14)/NFKB2 has been reported. Taken together, these data indicate that the MCL and SMZL arose as a consequence of independent malignant transformation events within an antigen-naive B-cell population. This case highlights the importance of a multidisciplinary approach and tissue diagnosis in these complex situations.
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Bendriss-Vermare N, Burg S, Kanzler H, Chaperot L, Duhen T, de Bouteiller O, D'agostini M, Bridon JM, Durand I, Sederstrom JM, Chen W, Plumas J, Jacob MC, Liu YJ, Garrone P, Trinchieri G, Caux C, Brière F. Virus overrides the propensity of human CD40L-activated plasmacytoid dendritic cells to produce Th2 mediators through synergistic induction of IFN-{gamma} and Th1 chemokine production. J Leukoc Biol 2005; 78:954-66. [PMID: 16081597 DOI: 10.1189/jlb.0704383] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Depending on the activation status, plasmacytoid dendritic cells (PDC) and myeloid DC have the ability to induce CD4 T cell development toward T helper cell type 1 (Th1) or Th2 pathways. Thus, we tested whether different activation signals could also have an impact on the profile of chemokines produced by human PDC. Signals that induce human PDC to promote a type 1 response (i.e., viruses) and a type 2 response [i.e., CD40 ligand (CD40L)] also induced PDC isolated from tonsils to secrete chemokines preferentially attracting Th1 cells [such as interferon-gamma (IFN-gamma)-inducible protein (IP)-10/CXC chemokine ligand 10 (CXCL10) and macrophage inflammatory protein-1beta/CC chemokine ligand 4 (CCL4)] or Th2 cells (such as thymus and activation-regulated chemokine/CCL17 and monocyte-derived chemokine/CCL22), respectively. Activated natural killer cells were preferentially recruited by supernatants of virus-activated PDC, and supernatants of CD40L-activated PDC attracted memory CD4(+) T cells, particularly the CD4(+)CD45RO(+)CD25(+) T cells described for their regulatory activities. It is striking that CD40L and virus synergized to trigger the production of IFN-gamma by PDC, which induces another Th1-attracting chemokine monokine-induced by IFN-gamma/CXCL9 and cooperates with endogenous type I IFN for IP-10/CXCL10 production. In conclusion, our studies reveal that PDC participate in the selective recruitment of effector cells of innate and adaptive immune responses and that virus converts the CD40L-induced Th2 chemokine patterns of PDC into a potent Th1 mediator profile through an autocrine loop of IFN-gamma.
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Garban F, Drillat P, Makowski C, Jacob MC, Richard MJ, Favrot M, Sotto JJ, Bensa JC, Cahn JY. Extracorporeal chemophototherapy for the treatment of graft-versus-host disease: hematologic consequences of short-term, intensive courses. Haematologica 2005; 90:1096-101. [PMID: 16079109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Extracorporeal chemophototherapy (ECP) is considered an immunomodulatory agent useful in both acute and chronic graft-versus-host disease (GVHD). Little is known about the best treatment schedule, and there are no data concerning hematologic parameters and cellular compositions of products during the treatment. DESIGN AND METHODS This was a single-center study of 27 patients treated with ECP for corticoresistant GVHD. Treatment was given in a short-term series of six courses over 3 weeks, and in case of response, consolidation treatment was given until complete response or stabilization of lesions. RESULTS Nine out of 12 patients with acute GVHD responded to treatment. In patients with chronic GVHD, 13 out of 15 patients responded (11 complete and 2 partial responses). Responses were obtained essentially in skin or gut lesions; ECP was of particular effect in three cases of bronchiolitis obliterans associated with transplantation, with all three patients responding. Hematologic consequences were studied in patients with chronic GVHD: hemoglobin levels increased significantly after treatment and a reduction in red blood cell transfusion requirements was also observed. INTERPRETATION AND CONCLUSIONS ECP is effective in both chronic and acute GVHD, particularly in lung forms. ECP can reduce the duration of immunosuppressive therapy and improve erythroid recovery. ECP product quality, including standardization for the number of mononuclear cells for each patient, needs further investigation.
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Affiliation(s)
- Frédéric Garban
- Département de Cancérologie et d'Hématologie, CHU de Grenoble BP217, 38043 Grenoble, France.
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35
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Garnache-Ottou F, Chaperot L, Biichle S, Ferrand C, Remy-Martin JP, Deconinck E, de Tailly PD, Bulabois B, Poulet J, Kuhlein E, Jacob MC, Salaun V, Arock M, Drenou B, Schillinger F, Seilles E, Tiberghien P, Bensa JC, Plumas J, Saas P. Expression of the myeloid-associated marker CD33 is not an exclusive factor for leukemic plasmacytoid dendritic cells. Blood 2004; 105:1256-64. [PMID: 15388576 DOI: 10.1182/blood-2004-06-2416] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A new entity of acute leukemia coexpressing CD4(+)CD56(+) markers without any other lineage-specific markers has been identified recently as arising from lymphoid-related plasmacytoid dendritic cells (pDCs). In our laboratory, cells from a patient with such CD4(+)CD56(+) lineage-negative leukemia were unexpectedly found to also express the myeloid marker CD33. To confirm the diagnosis of pDC leukemia despite the CD33 expression, we demonstrated that the leukemic cells indeed exhibited pDC phenotypic and functional properties. In 7 of 8 other patients with CD4(+)CD56(+) pDC malignancies, we were able to confirm that the tumor cells expressed CD33 although with variable expression levels. CD33 expression was shown by flow cytometry, reverse transcriptase-polymerase chain reaction, and immunoblot analysis. Furthermore, CD33 monoclonal antibody stimulation of purified CD4(+)CD56(+) leukemic cells led to cytokine secretion, thus confirming the presence of a functional CD33 on these leukemic cells. Moreover, we found that circulating pDCs in healthy individuals also weakly express CD33. Overall, our results demonstrate that the expression of CD33 on CD4(+)CD56(+) lineage-negative cells should not exclude the diagnosis of pDC leukemia and underline that pDC-specific markers should be used at diagnosis for CD4(+)CD56(+) malignancies.
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Affiliation(s)
- Francine Garnache-Ottou
- Etablissement Français du Sang Bourgogne Franche-Comté, Unité mixte EFS/Université EA2284/Inserm U645, IFR133, Besançon, France
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36
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Chaperot L, Perrot I, Jacob MC, Blanchard D, Salaun V, Deneys V, Lebecque S, Brière F, Bensa JC, Plumas J. Leukemic plasmacytoid dendritic cells share phenotypic and functional features with their normal counterparts. Eur J Immunol 2004; 34:418-26. [PMID: 14768046 DOI: 10.1002/eji.200324531] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This work aims to further characterize the newly described leukemic plasmacytoid dendritic cells (LPDC), for which we had previously demonstrated their normal, PDC-like ability to produce IFN-alpha. In addition, LPDC also express the specific antigens BDCA-2 and BDCA-4. Importantly, they become fully competent antigen-presenting cells (APC) after a short maturation induced by IL-3 + CD40L or virus, exhibiting a characteristic APC phenotype (high expression of CD83 and of the costimulatory molecules CD40, CD80, CD86). Whereas IL-3 + CD40L-activated LPDC prime naive CD4(+) T cells towards a Th2 pathway (IL-4-secreting T cells), virus-activated LPDC drive a Th1 profile (IFN-gamma-secreting T cells). Moreover, we show in one case that LPDC are able to capture, process and present exogenous antigens, leading to the activation of both CD4(+) and CD8(+) T cell clones in an antigen-specific manner. This study further characterizes the phenotype and immunological functions of LPDC.
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Affiliation(s)
- Laurence Chaperot
- Department of Research and Development, EFS Rhône-Alpes Grenoble, La Tronche, France.
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37
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Plumas J, Drillat P, Jacob MC, Richard MJ, Favrot MC. [Extracorporeal photochemotherapy for treatment of clonal T cell proliferations]. Bull Cancer 2003; 90:763-70. [PMID: 14609767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Extracorporeal photochimiotherapy (ECP) is based on the exposure of peripheral blood mononuclear cells to the photosensitizing agent (psoralen or 8MOP) and UVA radiation. Mononuclear cells are harvested by cytapheresis and reinfused to the patient after irradiation. This cell therapy has been shown to be effective in the treatment of selected diseases mediated by clonal T cells proliferation such as Sezary T cells lymphoma, rejection after solid organ transplantation and graft-versus-host disease but results obtained in autoimmune diseases are less convincing. ECP is well tolerated with very few side effects and can be combined with immunosuppressive drugs. Two methods of ECP are currently used: in the first one, the whole procedure is performed with the same equipment whereas in the second one, the cytapheresis is performed on a conventional cell separator and treated with an independent UVA irradiation: Experimental data and clinical results suggest that PCE might induced an immune response against pathological T cells clones. However, technical differences in the methods of PCE and weak knowledge on its mechanism of action impair the standardization and evaluation of this cell therapy process as well as its clinical development.
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Affiliation(s)
- Joël Plumas
- Unité mixte de therapie cellulaire et tissulaire, EFS Rhône Alpes, BP 35, 38701, La Tronche, France
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38
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Jacob MC, Manches O, Drillat P, Richard MJ, Plumas J, Chaperot L, Hegelhofer H, Garban F, Gressin R, Favrot M, Bensa JC, Pernollet M. Quality control for the validation of extracorporeal photopheresis process using the Vilbert-Lourmat UV-A irradiation's system. Transfus Apher Sci 2003; 28:63-70. [PMID: 12620270 DOI: 10.1016/s1473-0502(02)00101-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In agreement with good practices for therapeutic use of human cells, quality control has to be performed to valid the process of extracorporeal photopheresis (ECP) with the Vilbert-Lourmat system. Since no protocol exists, we evaluated a technique based on the measurement of the inhibition of mitogen (PHA, Con-A, OKT3)-induced proliferation, in 164 procedures from 16 patients. Whatever the pathology, we observed a high proliferation rate in most samples, and we obtained over 90% ECP-induced inhibition in as many as 94% of the cases. Since this approach proved to be relevant regarding our objective, a protocol for the ECP process validation is proposed.
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Affiliation(s)
- Marie-Christine Jacob
- Laboratory of Immunology, UMTCT, Rhône-Alpes French Blood Establishment, site of Grenoble, 29 avenue du maquis du Grésivaudan, 38701 La-Tronche, France.
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39
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Manches O, Lui G, Chaperot L, Gressin R, Molens JP, Jacob MC, Sotto JJ, Leroux D, Bensa JC, Plumas J. In vitro mechanisms of action of rituximab on primary non-Hodgkin lymphomas. Blood 2003; 101:949-54. [PMID: 12393572 DOI: 10.1182/blood-2002-02-0469] [Citation(s) in RCA: 261] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
To assess the sensitivity of primary non-Hodgkin lymphoma cells to rituximab-mediated cytotoxicity, we compared the potency of several rituximab-mediated killing mechanisms on fresh lymphoma cells. All lymphoma cells tested were equally sensitive to antibody-dependent cell-mediated cytotoxicity (ADCC), antibody-mediated phagocytosis of tumor cells, and rituximab-induced apoptosis. However, they were differentially lysed by complement-dependent cytotoxicity (CDC). We found that taking into account both CD20 and complement regulatory protein expression on tumor cells could predict CDC sensitivity in vitro. Importantly, the sensitivity of lymphoma cells to CDC was consistent with the reported different clinical response rates of lymphomas: rituximab induced high CDC killing of follicular lymphoma cells, whereas mantle cell lymphoma and diffuse large cell lymphoma cells were moderately sensible to CDC, and small lymphocytic lymphoma cells were almost all resistant. We propose that CDC is a determinant mechanism of rituximab-induced killing in vivo. Poor sensitivity to CDC in vitro might predict a poor clinical response, whereas high sensitivity to CDC would only indicate a likelihood of response to rituximab treatment.
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MESH Headings
- Antibodies, Monoclonal/pharmacology
- Antibodies, Monoclonal, Murine-Derived
- Antigens, CD20/analysis
- Antigens, CD20/immunology
- Antigens, Neoplasm/analysis
- Antigens, Neoplasm/immunology
- Apoptosis/drug effects
- B-Lymphocytes/drug effects
- B-Lymphocytes/immunology
- B-Lymphocytes/pathology
- Case-Control Studies
- Cell Death/drug effects
- Complement System Proteins
- Cytotoxicity, Immunologic/drug effects
- Humans
- Lymph Nodes/pathology
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/pathology
- Lymphoma, Non-Hodgkin/drug therapy
- Lymphoma, Non-Hodgkin/pathology
- Phagocytosis/drug effects
- Rituximab
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Affiliation(s)
- Olivier Manches
- Department of Research and Development, EFS Rhône-Alpes, and Research Group on Lymphoma, Albert Bonniot Institute, La Tronche, France
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40
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Brière F, Bendriss-Vermare N, Delale T, Burg S, Corbet C, Rissoan MC, Chaperot L, Plumas J, Jacob MC, Trinchieri G, Bates EEM. Origin and filiation of human plasmacytoid dendritic cells. Hum Immunol 2002; 63:1081-93. [PMID: 12480251 DOI: 10.1016/s0198-8859(02)00746-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Human plasmacytoid dendritic cells represent a rare population of leukocytes which produce high amounts of type I interferon in response to certain viruses. Although those cells were first described in 1958, there are still unsolved issues related to their origin and function. Recently, a leukemic counterpart of plasmacytoid dendritic cells was identified. Molecular approaches using either normal or leukemic plasmacytoid dendritic cells provide some new insights into the controversial lymphoid origin of those cells. The need for specific markers is still a critical aspect for the identification of plasmacytoid dendritic cells, whatever stage of differentiation, in normal as well as in pathological conditions. Hopefully, novel markers will allow delineation of the relationships between dendritic cells at different stages of differentiation/maturation along the myeloid and lymphoid lineages.
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Affiliation(s)
- Francine Brière
- Laboratory for Immunological Research, Schering-Plough, Dardilly, France.
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41
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Chaperot L, Manches O, Mi JQ, Moine A, Jacob MC, Gressin R, Molens JP, Sotto JJ, Leroux D, Bensa JC, Plumas J. Differentiation of anti-tumour cytotoxic T lymphocytes from autologous peripheral blood lymphocytes in non-Hodgkin's lymphomas. Br J Haematol 2002; 119:425-31. [PMID: 12406081 DOI: 10.1046/j.1365-2141.2002.03885.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We have previously reported that specific anti-tumour cytotoxic T cells (CTL) can be differentiated from tumour-infiltrating lymphocytes (TIL) in non-Hodgkin's lymphoma. We found that the combination of interleukin (IL)-1, IL-2 and IL-12 was very efficient for expansion of CD8+ T-cell receptor (TCR)alphabeta+ T cells and for development of their ability to specifically lyse tumour cells. In this study, we investigated whether anti-tumour T cells could be generated from the peripheral blood of patients using the culture protocol developed for TIL. Autologous T cells and tumour B cells from five patients were included in this study. It was found that polyclonal anti-tumour cytotoxic effector cells were generated when cultured in the presence of IL-1beta, IL-2 and IL-12. Interestingly, tumour cells were lysed by perforin/granzyme-mediated cytolysis and not by CD95-mediated apoptosis. By performing inhibition experiments, it was observed that both CD8+ and CD4+ T cells were responsible for the cytotoxic effect and that they were able to recognize malignant B cells by either a major histocompatibility complex (MHC)-restricted or MHC-non-restricted mechanism. Intriguingly, in addition to interferon-gamma and tumour necrosis factor-alpha, IL-10 was secreted continuously during culture. The source of patient T cells used for the generation of anti-tumour CTL should be based on the results obtained with peripheral blood lymphocytes and TIL.
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42
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Maynadié M, Gerland L, Aho S, Girodon F, Bernier M, Brunet C, Campos L, Daliphard S, Deneys V, Falkenrodt A, Jacob MC, Kühlein E, LeCalvez G, Moskovtchenko P, Philip P, Carli PM, Faure GC, Béné MC. Clinical value of the quantitative expression of the three epitopes of CD34 in 300 cases of acute myeloid leukemia. Haematologica 2002; 87:795-803. [PMID: 12161354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The various epitopes of the CD34 molecule have been classified according to their different sensitivities to enzymatic cleavage by neuraminidase, chymopapain and a glycoprotease from Pasteurella haemolytica. Although monoclonal antibodies have been developed that specifically identify these epitopes, few studies have evaluated the distribution and quantitative expression of such epitopes on leukemic blasts. DESIGN AND METHODS We report here a prospective multicenter study in which we examined and quantified the expression of the 3 classes of CD34 on fresh leukemic blast cells from 300 cases of acute myeloid leukemia (AML). The binding of monoclonal antibodies was studied by flow cytometry, allowing evaluation of blast cell positivity as well as their mean fluorescence intensity. These quantitative data were made comparable between centers by means of a calibration curve established with the same reagents in all laboratories. RESULTS Quantitative expression of class I epitope was significantly higher than that of class II and class III epitopes (p<0.0001). The three classes were more frequently expressed in M0 and M1 and less in M3 and M5. The highest levels of CD34 expression were observed in M2, M0 and M1 and the lowest in M3, M5 and BAL for class II and III. CD34 expression was lower for all classes in cases with a normal karyotype, compared to in cases with structural or numerical abnormalities. INTERPRETATION AND CONCLUSIONS In cases with a t(9;22) the expression of class I was significantly higher than that of class II and III and the opposite was observed in AML with t(15;17). Moreover, as a whole, a high intensity of class III CD34 appeared to be a marker of good prognosis.
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Affiliation(s)
- Marc Maynadié
- Service d'Hématologie biologique, CHU de Dijon, 2 Boulevard Maréchal de Lattre de Tassigny, 21034 Dijon Cedex, France.
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43
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Garban F, Gallagher M, Jouvin-Marche E, Jacob MC, Moine A, Marche PN, Sotto JJ. Immunotherapy by non-myeloablative stem cell transplantation: study of the immune reconstitution. Arguments for distinct cell subsets in skin and blood. Hematol J 2002; 1:274-81. [PMID: 11920202 DOI: 10.1038/sj.thj.6200044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/1999] [Accepted: 03/14/2000] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Non-myeloablative peripheral stem cell transplantation has been shown to induce tumour rejection in patients with acute leukaemia. However, the immunological mechanisms involved and the immune reconstitution achieved have not been investigated. MATERIALS AND METHODS We describe the cases of two patients for whom we have studied the lymphocyte reconstitution achieved, using both phenotypic and genetic analyses of the T-cell repertoire, after peripheral stem cell transplantation. RESULTS : In both cases we observed immune reconstitution with T-cell repertoire evolution and presence of activated CD8(+) T cells. In one of the patients an activated clone expressing Vbeta8 represents 46% of the CD8(+) cells. Expansion of this clone occurred in the absence of graft vs host disease symptoms. In the second case a skin lesion typical of graft vs host disease appeared after complete remission had been achieved. The T-cell repertoire in a biopsy of the lesion was distinct from that observed in the blood. CONCLUSION Our study indicates that peripheral donor cells can effectively reconstitute a grafted patient while inducing an immune response against antigens expressed by the leukaemic/myeloma cells. Our data provide arguments for different populations of T cells associated with graft vs leukaemia/lymphoma and GVH effects.
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Affiliation(s)
- F Garban
- Department of Haematology, CHU de Grenoble, 38043 Grenoble cedex 9, France.
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44
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Feuillard J, Jacob MC, Valensi F, Maynadié M, Gressin R, Chaperot L, Arnoulet C, Brignole-Baudouin F, Drénou B, Duchayne E, Falkenrodt A, Garand R, Homolle E, Husson B, Kuhlein E, Le Calvez G, Sainty D, Sotto MF, Trimoreau F, Béné MC. Clinical and biologic features of CD4(+)CD56(+) malignancies. Blood 2002; 99:1556-63. [PMID: 11861268 DOI: 10.1182/blood.v99.5.1556] [Citation(s) in RCA: 276] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
CD4(+)CD56(+) malignancies are rare hematologic neoplasms, which were recently shown to correspond to the so-called type 2 dendritic cell (DC2) or plasmacytoid dendritic cells. This study presents the biologic and clinical features of a series of 23 such cases, selected on the minimal immunophenotypic criteria defining the DC2 leukemic counterpart, that is, coexpression of CD4 and CD56 in the absence of B, T, and myeloid lineage markers. Clinical presentation typically corresponded to cutaneous nodules associated with lymphadenopathy or spleen enlargement or both. Cytopenia was frequent. Circulating malignant cells were often detected. Massive bone marrow infiltration was seen in 20 of 23 (87%) patients. Most tumor cells exhibited nuclei with a lacy chromatin, a blastic aspect, large cytoplasm-containing vacuoles or microvacuoles beside the plasma membrane, and cytoplasmic expansions resembling pseudopodia. Other immunophenotypic characteristics included both negative (CD16, CD57, CD116, and CD117) and positive (CD36, CD38, CD45 at low levels, CD45RA, CD68, CD123, and HLA DR) markers. The prognosis was rapidly fatal in the absence of chemotherapy. Complete remission was obtained in 18 of 23 (78%) patients after polychemotherapy. Most patients had a relapse in less than 2 years, mainly in the bone marrow, skin, or central nervous system. Considering these clinical and biologic features, the conclusion is made that CD4(+)CD56(+) malignancies constitute a genuine homogeneous entity. Furthermore, some therapeutic options were clearly identified. Finally, relationships between the pure cutaneous indolent form of the disease and acute leukemia as well as with the lymphoid/myeloid origin of the CD4(+)CD56(+) malignant cell are discussed.
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Affiliation(s)
- Jean Feuillard
- Service d'Hématologie Biologique, Hôpital Avicenne, Université Paris 13 Bobigny, France.
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45
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Chaperot L, Bendriss N, Manches O, Gressin R, Maynadie M, Trimoreau F, Orfeuvre H, Corront B, Feuillard J, Sotto JJ, Bensa JC, Brière F, Plumas J, Jacob MC. Identification of a leukemic counterpart of the plasmacytoid dendritic cells. Blood 2001; 97:3210-7. [PMID: 11342451 DOI: 10.1182/blood.v97.10.3210] [Citation(s) in RCA: 251] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This work aims to demonstrate that CD4(+)CD56(+) malignancies arise from transformed cells of the lymphoid-related plasmacytoid dendritic cell (pDC) subset. The analysis of malignant cells from 7 patients shows that in all cases, like pDCs, leukemic cells are negative for lineage markers CD3, CD19, CD13, CD33, and CD11c but express high levels of interleukin-3 receptor alpha chain (IL-3Ralpha), HLA-DR, and CD45RA. Tumor cells produce interferon-alpha in response to influenza virus, while upon maturation with IL-3 they become a powerful inducer of naive CD4(+) T-cell proliferation and promote their T-helper 2 polarization. As pDCs, leukemic cells also express pre-Talpha and lambda-like 14.1 transcripts, arguing in favor of a lymphoid origin. In addition, malignant cells express significant levels of CD56 and granzyme B. Overall, those observations suggest that CD4(+)CD56(+) leukemic cells could represent the malignant counterpart of pDCs, both of which are closely related to B, T, and NK cells.
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Affiliation(s)
- L Chaperot
- Department of Research and Development, Research Group on Lymphoma, EFS Rhône-Alpes Grenoble, La Tronche, France.
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46
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Jacob MC. Factoring Mary Poovey's A History of the Modern Fact. Hist Theory 2001; 40:280-289. [PMID: 18680883 DOI: 10.1111/0018-2656.00168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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47
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Irisarri M, Plumas J, Bonnefoix T, Jacob MC, Roucard C, Pasquier MA, Sotto JJ, Lajmanovich A. Resistance to CD95-mediated apoptosis through constitutive c-FLIP expression in a non-Hodgkin's lymphoma B cell line. Leukemia 2000; 14:2149-58. [PMID: 11187905 DOI: 10.1038/sj.leu.2401954] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CD95 (Fas/Apo-1) is a transmembrane molecule that induces apoptosis and plays a central role in the regulation of the immune response. The present study describes two new B lymphoid cell lines, B593 and BR97, derived from non-Hodgkin's lymphoma, which differ in susceptibility to CD95-mediated apoptosis. While B593 cells are sensitive to CD95mediated apoptosis, BR97 cells are completely resistant. Activation of caspase-8 and caspase-3 proteases plays an important role in the CD95 signalling pathway. CD95 stimulation induced caspase-8 and caspase-3 activation in B593, but not in BR97 cells. However, activation of both caspase-8 and caspase-3 was achieved in BR97 cells treated with staurosporine. Furthermore, protein synthesis inhibition by cycloheximide restored sensitivity to CD95-mediated apoptosis and allowed activation of both caspase-8 and caspase-3 in BR97 cells. These results indicate that, in BR97 cells, both caspases are functional and suggest that CD95-apoptosis resistance may result from the presence of inhibitory factor(s). Constitutive high level expression of the apoptotic inhibitor c-FLIP was observed in the CD95-resistant BR97 cell line compared to B593. Moreover, downregulation of c-FLIP expression level by protein synthesis inhibition strictly correlated with restored sensitivity to CD95-mediated apoptosis in BR97 cells. Furthermore, we demonstrate that c-FLIP is recruited to the CD95 DISC in BR97 cells together with caspase-8 and FADD. The data presented in this study strongly suggests that, in a B-NHL-derived cell line, resistance to CD95-mediated apoptosis results from endogenous high level expression of apoptotic inhibitor c-FLIP.
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Affiliation(s)
- M Irisarri
- Research Group on Lymphoma, Albert Bonniot Institute, University Joseph Fourier, La Tronche, France
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48
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Chaperot L, Chokri M, Jacob MC, Drillat P, Garban F, Egelhofer H, Molens JP, Sotto JJ, Bensa JC, Plumas J. Differentiation of antigen-presenting cells (dendritic cells and macrophages) for therapeutic application in patients with lymphoma. Leukemia 2000; 14:1667-77. [PMID: 10995015 DOI: 10.1038/sj.leu.2401888] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The recent clinical trial in lymphoma using tumor antigen-loaded DCs (Hsu et al, Nature Med 1996; 2: 52) demonstrates the efficiency of the use of professional antigen presenting cells (APCs) for taking up, processing and presenting tumor protein in a vaccine strategy in cancer. However, the production of large quantities of clinical grade APCs remains to be resolved. Here, we describe that both dendritic cells (DCs) and macrophages (MOs) can be efficiently differentiated in large numbers from lymphoma patients in spite of their disease and previous therapy. These cells were produced using the VAC and MAK cell processors according to standard operating procedures. DCs and MOs were differentiated from circulating monocytes in gas permeable hydrophobic bags, with 2% autologous serum and in the presence of GM-CSF and IL-13 or GM-CSF alone, respectively. DCs and MOs were then purified by counter flow centrifugation. Phenotypic, morphological and functional analysis showed that cells differentiated from patients with lymphoma present quite similar features to DCs and MOs produced from monocytes of healthy donors. Moreover, we show that MOs, when combined with CD20 antibody (Rituximab), can efficiently engulf tumor cells and propose that a such combination could be used for initiating a clinical trial in lymphoma. Thus, the possibility of producing functional DC and MOs in large amounts in conditions compatible with therapeutic application will allow the development of new immune strategies to eradicate lymphoma.
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Affiliation(s)
- L Chaperot
- Cell Therapy Department, ETS Isère-Savoie, La Tronche, France
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Chaperot L, Jacob MC, Molens JP, Manches O, Bensa JC, Plumas J. From the study of tumor cell immunogenicity to the generation of antitumor cytotoxic cells in non-Hodgkin's lymphomas. Leuk Lymphoma 2000; 38:247-63. [PMID: 10830732 DOI: 10.3109/10428190009087016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The question of the immunogenicity of non-Hodgkin's lymphoma (NHL) B cells has been investigated in an attempt to support the development of new immunotherapeutic treatments for this disorder, which remains resistant to conventional treatments in most cases. In the present review, we report and discuss our new findings in the field of NHL B cell immunogenicity. One aspect of our work is the description of the expression and functions of membrane molecules associated with antigen presentation. The expression levels of adhesion molecules was measured, and the relevance of this expression to the sensitivity of malignant B cells to cell-mediated lysis was studied. Since the T cell response relies on the expression of both HLA class I and II molecules, we also investigated whether or not these molecules were present at the surface of NHL B cells. Subsequently, we asked whether antitumor CTL and LAK cells could be developed and analyzed the mechanisms of cell lysis involved. Since the generation of a T cell response requires the expression of the costimulatory molecules CD80 and CD86, we investigated their in vivo expression and their modulation in vitro during contact with responding T lymphocytes. The understanding of the immunogenicity of NHL B cells has enabled us to develop a new culture protocol to induce antitumor specific autologous CTL. The originality of NHL B cells--unlike most other tumor cells--is to be able to function as antigen presenting cells (APC) and to activate a T cell response in the absence of other professional APC. Over the next few years, these findings should allow the generation of anti-NHL specific T cells for adoptive immunotherapy and for the identification of NHL-associated antigens.
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MESH Headings
- Antigen Presentation
- Antigen-Presenting Cells/immunology
- Antigens, CD/biosynthesis
- Antigens, CD/genetics
- Antigens, CD/immunology
- Antigens, Neoplasm/biosynthesis
- Antigens, Neoplasm/genetics
- Antigens, Neoplasm/immunology
- Antigens, Surface/immunology
- Antigens, Surface/metabolism
- B-Lymphocytes/immunology
- B7-1 Antigen/biosynthesis
- B7-1 Antigen/genetics
- B7-1 Antigen/immunology
- B7-2 Antigen
- Cell Adhesion Molecules/biosynthesis
- Cell Adhesion Molecules/genetics
- Cell Adhesion Molecules/immunology
- Cells, Cultured
- Cytotoxicity, Immunologic
- Fas Ligand Protein
- Gene Expression Regulation, Neoplastic
- HLA Antigens/biosynthesis
- HLA Antigens/genetics
- HLA Antigens/immunology
- Humans
- Immunotherapy, Adoptive
- Killer Cells, Lymphokine-Activated/immunology
- Lymphocytes, Tumor-Infiltrating/immunology
- Lymphoma, B-Cell/immunology
- Lymphoma, B-Cell/therapy
- Membrane Glycoproteins/biosynthesis
- Membrane Glycoproteins/genetics
- Membrane Glycoproteins/immunology
- Neoplastic Stem Cells/immunology
- T-Lymphocytes, Cytotoxic/immunology
- fas Receptor/biosynthesis
- fas Receptor/genetics
- fas Receptor/immunology
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Affiliation(s)
- L Chaperot
- Laboratoire de Recherche et de Développement, ETS Isère et Savoie, La Tronche, France.
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Seinturier C, Péoch M, Morand P, Jacob MC, Gressin R, Brion JP. [Malignant non-Hodgkins B lymphoma related to Epstein-Barr virus and chronic natural killer lymphocytosis in a immunocompromised patient]. Rev Med Interne 2000; 21:290-4. [PMID: 10763192 DOI: 10.1016/s0248-8663(00)80050-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Immunocompromised patients are at high risk of Epstein-Barr virus (EBV)-related lymphoproliferative disorders. The lymphoproliferation affects B, T, and natural killer (NK) cells. EXEGESIS We report the case of a woman suffering from systemic lupus erythematous. She developed an opportunistic pneumonia while immunodepressed during long-term corticotherapy aimed at curing her auto-immune disease. Chronic lymphocytosis was also diagnosed at this time. Several months later, non-Hodgkin's lymphoma was diagnosed. Genomic amplification of the Epstein-Barr virus in the patient's blood and positive EBV latent membrane protein 1 on the lymph nodes provided evidence for a strong correlation between EBV reactivation and lymphoma. CONCLUSION Two distinct lymphoid diseases occurred during the immunosuppressive therapy for the auto-immune disease. PCR monitoring of Epstein-Barr virus allows for early screening of lymphoproliferative disorders in immunocompromised patients, leading to earlier and more efficient treatment.
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Affiliation(s)
- C Seinturier
- Clinique des maladies infectieuses, CHU, Grenoble, France
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