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Simon AL, Hallé A, Tanase A, Peuchmaur M, Jehanno P, Ilharreborde B. Is magnetic resonance imaging reliable for assessing osteosarcoma of the knee joint in children? Orthop Traumatol Surg Res 2021; 109:103086. [PMID: 34597827 DOI: 10.1016/j.otsr.2021.103086] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/12/2020] [Accepted: 09/24/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The study of tumor extension in knee osteosarcomas is an essential diagnostic tool that helps determine the surgical approach. Magnetic resonance imaging (MRI) is the key component in this decision-making process, but the interpretation of signals can be difficult because peritumoral edema and inflammation may be mistaken for the tumor. HYPOTHESIS There is a discrepancy between MRI and histopathology findings in the assessment of joint involvement in pediatric osteosarcomas of the knee. MATERIALS AND METHODS All children who underwent an extra-articular resection for an osteosarcoma of the knee between 2007 and 2016 were included. This was indicated if there was at least one of the following MRI signs: presence of articular effusion, involvement of either the peripheral capsuloligamentous structures, central pivot or patella, or lesion abutting the articular cartilage. RESULTS Nine patients were operated on with a mean age of 13±2.7 years. There were at least two of the described signs, mainly the involvement of the peripheral capsuloligamentous structures (78%) and central pivot (56%). The histopathology confirmed that the resection margins were healthy in all cases, but the indication for extra-articular resection could have been avoided in 89% of them. DISCUSSION MRI is the current gold standard for assessing tumor extension, but the signs contraindicating the transarticular approach remain poorly defined. Joint effusion detected by clinical or radiological assessment is the least reliable one. It seems that the tumor's proximity to the articular cartilage, as long as there is no loss of continuity in the latter, or its extension into the central pivot should no longer be considered as relevant signs. The involvement of the peripheral capsuloligamentous structure remains an indication criterion because oncologic resection is otherwise impossible, and the risk of false-negative histopathologic diagnoses is higher. Other MRI sequences could better assess the true extension into the joint space. LEVEL OF EVIDENCE IV, retrospective study.
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Affiliation(s)
- Anne-Laure Simon
- Service de chirurgie infantile à orientation orthopédique, hôpital universitaire Robert-Debré, université de Paris, AP-HP, 48, boulevard Sérurier, 75019 Paris, France.
| | - Aurélien Hallé
- Service de chirurgie infantile à orientation orthopédique, hôpital universitaire Robert-Debré, université de Paris, AP-HP, 48, boulevard Sérurier, 75019 Paris, France
| | - Anca Tanase
- Service de radiologie pédiatrique, hôpital Robert-Debré, université de Paris, AP-HP, 48, boulevard Sérurier, 75019 Paris, France
| | - Michel Peuchmaur
- Service d'Anatomie et de Cytologie pathologiques, hôpital Robert-Debré, université de Paris, AP-HP, 48, boulevard Sérurier, 75019 Paris, France
| | - Pascal Jehanno
- Service de chirurgie infantile à orientation orthopédique, hôpital universitaire Robert-Debré, université de Paris, AP-HP, 48, boulevard Sérurier, 75019 Paris, France
| | - Brice Ilharreborde
- Service de chirurgie infantile à orientation orthopédique, hôpital universitaire Robert-Debré, université de Paris, AP-HP, 48, boulevard Sérurier, 75019 Paris, France
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Deflorenne E, Peuchmaur M, Vezzosi D, Ajzenberg C, Brunaud L, Chevalier N, Christin-Maitre S, Decoudier B, Driessens N, Drui DD, Gilly O, Goudet P, Illouz F, Jublanc C, Lefebvre H, Lopez AG, Lussey C, Morini A, Raffin-Sanson ML, Raingeard I, Renoult-Pierre P, Storey C, Tabarin A, Vantyghem MC, Vidal-Petiot E, Baudin E, Bertherat J, Amar L. Adrenal ganglioneuromas: a retrospective multicentric study of 104 cases from the COMETE network. Eur J Endocrinol 2021; 185:463-474. [PMID: 34291731 DOI: 10.1530/eje-20-1049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 07/06/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Adrenal ganglioneuromas are rare, differentiated, neuroblastic tumors that originate from the peripheral sympathetic nervous system. Because of their rarity, information is limited, derived from small cases series. Our objective was to characterize this tumor and provide help for its management. METHODS A retrospective multicenter analysis of adrenal ganglioneuromas from 20 French centers belonging to the COMETE network and one Belgian center. RESULTS Among the 104 cases identified, 59.6% were women (n = 62/104), median age at diagnosis was 29 years, with 24 pediatric cases. 60.6% (n = 63/104) were incidentalomas. Ganglioneuromas were non-secreting tumors in 90.8% of cases (n = 89/98), whereas the preoperative hormonal evaluation was indeterminate for 9.2% of patients (n = 9/98). CT imaging, performed on 96 patients, revealed large tumors (median diameter of 50 mm) with a non-contrast density > 10 Hounsfield units in 98.1% (n = 52/53) and calcifications in 64.6% of cases (n = 31/48). Increased uptake on 123I-MIBG scintigraphy and 18F-FDG-PET/CT was observed in 26.7% (n = 8/30) and 42.2% (n = 19/45) of the tumors, respectively. All 104 patients underwent surgery. No recurrence was observed among the 42 patients who had an imaging follow-up (mean 29.6 months, median 18 months (4-156)). CONCLUSION Adrenal ganglioneuromas are large tumors, mostly nonfunctioning, without benign imaging features. Although the duration of follow-up was limited in our series, no recurrence was identified. A review of the literature confirms the absence of postoperative recurrence. Based on all available data, in the absence of special circumstances (genetic form, uncertain histological diagnosis), long-term follow-up is not necessary after complete surgery for patients with an adrenal ganglioneuroma.
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Affiliation(s)
- Elisa Deflorenne
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Centre de Référence des Maladies Rares de la Surrénale, Unité Fonctionnelle d 'Hypertension Artérielle, Université de Paris, Paris, France
- Sorbonne Université, Médecine Paris, France, undefined
- UMR970, Paris-Cardiovascular research Center, INSERM, F-75015, Paris, France
| | - Michel Peuchmaur
- Service de Pathologie, HU Robert Debré, APHP, Paris, France
- Université de Paris, Paris, France
| | | | - Christiane Ajzenberg
- Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Service de Médecine Interne et Endocrinologie, Créteil, France
| | - Laurent Brunaud
- Département de Chirurgie Viscérale, Métabolique et Cancérologique Unité Médico-chirurgicale de chirurgie Métabolique, Endocrinienne et Thyroïdienne (UMET), Université de Lorraine, CHU de Nancy, Hôpital Brabois Adultes, Nancy, France
| | - Nicolas Chevalier
- Université Côte d'Azur, Service d'Endocrinologie, Diabétologie et Reproduction, CHU de Nice, Hôpital de l'Archet 2, Nice, France
| | - Sophie Christin-Maitre
- Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Service d'Endocrinologie et Maladies de la Reproduction, Paris, France
| | - Bénédicte Decoudier
- Centre Hospitalier Universitaire de Reims, Service d'Endocrinologie-Diabète-Nutrition, Reims, France
| | - Natacha Driessens
- Département d'Endocrinologie, CUB-Hôpital Erasme, Bruxelles, Belgique
| | - Delphine D Drui
- Centre Hospitalier Universitaire de Nantes, Hôpital Nord Laënnec, Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, L'institut du Thorax, Nantes, France
| | - Olivier Gilly
- CHU de Nîmes, Service des Maladies Métaboliques et Endocriniennes, Nîmes, France
| | - Pierre Goudet
- CHU de Dijon, Chirurgie Endocrinienne et Métabolique, Dijon, France
| | - Frédéric Illouz
- Centre de Référence des Maladies Rares de la Thyroïde et des Récepteurs Hormonaux, Département d'Endocrinologie Diabétologie Nutrition, Angers, France
| | - Christel Jublanc
- Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Service d'Endocrinologie-Métabolisme, Institut E3M, Paris, France
| | - Hervé Lefebvre
- Université de Rouen Normandie, UNIROUEN, INSERM U1239, CHU de Rouen, Service d'Endocrinologie, Diabète et Maladies Métaboliques et CIC-CRB 1404, Rouen, France
| | - Antoine-Guy Lopez
- Université de Rouen Normandie, UNIROUEN, INSERM U1239, CHU de Rouen, Service d'Endocrinologie, Diabète et Maladies Métaboliques et CIC-CRB 1404, Rouen, France
| | - Charlotte Lussey
- Sorbonne Université, Hôpital Pitié-Salpêtrière, Service de Médecine Nucléaire, Paris, France
| | - Aurelien Morini
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Laboratoire d'Anatomo-Pathologie, Paris, France
| | - Marie-Laure Raffin-Sanson
- Assistance Publique-Hôpitaux de Paris, CHU Ambroise-Paré, Service d'Endocrinologie et Nutrition, Boulogne-Billancourt, France
| | - Isabelle Raingeard
- CHRU de Montpellier, Service d'Endocrinologie, Diabète, Maladies Métaboliques, Montpellier, France
| | - Peggy Renoult-Pierre
- Centre Hospitalier Universitaire de Tours, Département d'Endocrinologie, Tours, France
| | - Caroline Storey
- Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Paris, France
| | - Antoine Tabarin
- CHU de Bordeaux, Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, Bordeaux, France
| | - Marie Christine Vantyghem
- Centre Hospitalier Régional Universitaire de Lille, Service d'Endocrinologie et Maladies Métaboliques, Lille, France
| | - Emmanuelle Vidal-Petiot
- Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Service de Physiologie, Paris, France
| | - Eric Baudin
- Institut Gustave Roussy, Service de Médecine Nucléaire et de Cancérologie Endocrinienne, Villejuif, France
| | - Jerome Bertherat
- Université Paris Descartes, Hôpital Cochin, Centre de Référence des Maladies Rares de la Surrénale, Service d'Endocrinologie, Paris, France
| | - Laurence Amar
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Centre de Référence des Maladies Rares de la Surrénale, Unité Fonctionnelle d 'Hypertension Artérielle, Université de Paris, Paris, France
- UMR970, Paris-Cardiovascular research Center, INSERM, F-75015, Paris, France
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Fila M, Sassi A, Brideau G, Cheval L, Morla L, Houillier P, Walter C, Gennaoui M, Collignon L, Keck M, Planelles G, Bakouh N, Peuchmaur M, Deschênes G, Anegon I, Remy S, Vogt B, Crambert G, Doucet A. A variant of ASIC2 mediates sodium retention in nephrotic syndrome. JCI Insight 2021; 6:e148588. [PMID: 34166227 PMCID: PMC8410034 DOI: 10.1172/jci.insight.148588] [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: 02/16/2021] [Accepted: 06/23/2021] [Indexed: 11/17/2022] Open
Abstract
Idiopathic nephrotic syndrome (INS) is characterized by proteinuria and renal sodium retention leading to edema. This sodium retention is usually attributed to epithelial sodium channel (ENaC) activation after plasma aldosterone increase. However, most nephrotic patients show normal aldosterone levels. Using a corticosteroid-clamped (CC) rat model of INS (CC-PAN), we showed that the observed electrogenic and amiloride-sensitive Na retention could not be attributed to ENaC. We then identified a truncated variant of acid-sensing ion channel 2b (ASIC2b) that induced sustained acid-stimulated sodium currents when coexpressed with ASIC2a. Interestingly, CC-PAN nephrotic ASIC2b-null rats did not develop sodium retention. We finally showed that the expression of the truncated ASIC2b in the kidney was dependent on the presence of albumin in the tubule lumen and activation of ERK in renal cells. Finally, the presence of ASIC2 mRNA was also detected in kidney biopsies from patients with INS but not in any of the patients with other renal diseases. We have therefore identified a variant of ASIC2b responsible for the renal Na retention in the pathological context of INS.
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Affiliation(s)
- Marc Fila
- Cordeliers Research Center, Sorbonne University, INSERM, University of Paris, Laboratory of Renal Metabolism and Physiology, Paris, France.,CNRS, ERL8228, Paris, France
| | - Ali Sassi
- Cordeliers Research Center, Sorbonne University, INSERM, University of Paris, Laboratory of Renal Metabolism and Physiology, Paris, France.,CNRS, ERL8228, Paris, France
| | - Gaëlle Brideau
- Cordeliers Research Center, Sorbonne University, INSERM, University of Paris, Laboratory of Renal Metabolism and Physiology, Paris, France.,CNRS, ERL8228, Paris, France
| | - Lydie Cheval
- Cordeliers Research Center, Sorbonne University, INSERM, University of Paris, Laboratory of Renal Metabolism and Physiology, Paris, France.,CNRS, ERL8228, Paris, France
| | - Luciana Morla
- Cordeliers Research Center, Sorbonne University, INSERM, University of Paris, Laboratory of Renal Metabolism and Physiology, Paris, France.,CNRS, ERL8228, Paris, France
| | - Pascal Houillier
- Cordeliers Research Center, Sorbonne University, INSERM, University of Paris, Laboratory of Renal Metabolism and Physiology, Paris, France.,CNRS, ERL8228, Paris, France
| | - Christine Walter
- Cordeliers Research Center, Sorbonne University, INSERM, University of Paris, Laboratory of Renal Metabolism and Physiology, Paris, France.,CNRS, ERL8228, Paris, France
| | - Michel Gennaoui
- Cordeliers Research Center, Sorbonne University, INSERM, University of Paris, Laboratory of Renal Metabolism and Physiology, Paris, France.,CNRS, ERL8228, Paris, France
| | - Laure Collignon
- Cordeliers Research Center, Sorbonne University, INSERM, University of Paris, Laboratory of Renal Metabolism and Physiology, Paris, France.,CNRS, ERL8228, Paris, France
| | - Mathilde Keck
- Cordeliers Research Center, Sorbonne University, INSERM, University of Paris, Laboratory of Renal Metabolism and Physiology, Paris, France.,CNRS, ERL8228, Paris, France
| | - Gabrielle Planelles
- Cordeliers Research Center, Sorbonne University, INSERM, University of Paris, Laboratory of Renal Metabolism and Physiology, Paris, France.,CNRS, ERL8228, Paris, France
| | - Naziha Bakouh
- Cordeliers Research Center, Sorbonne University, INSERM, University of Paris, Laboratory of Renal Metabolism and Physiology, Paris, France.,CNRS, ERL8228, Paris, France
| | | | - Georges Deschênes
- Pediatric Nephrology Department, Robert Debré Hospital, Paris, France
| | - Ignacio Anegon
- INSERM UMR 1064, Center for Research in Transplantation and Immunology Transgenic Rats ImmunoPhenomic Facility, Nantes, France
| | - Séverine Remy
- INSERM UMR 1064, Center for Research in Transplantation and Immunology Transgenic Rats ImmunoPhenomic Facility, Nantes, France
| | - Bruno Vogt
- Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Gilles Crambert
- Cordeliers Research Center, Sorbonne University, INSERM, University of Paris, Laboratory of Renal Metabolism and Physiology, Paris, France.,CNRS, ERL8228, Paris, France
| | - Alain Doucet
- Cordeliers Research Center, Sorbonne University, INSERM, University of Paris, Laboratory of Renal Metabolism and Physiology, Paris, France.,CNRS, ERL8228, Paris, France
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Lambert S, Peycelon M, Samara-Boustani D, Hyon C, Dumeige L, Peuchmaur M, Fiot E, Léger J, Simon D, Paye-Jaouen A, Bouligand J, Siffroi JP, Carel JC, McElreavey K, El Ghoneimi A, Brachet C, Bouvattier C, Martinerie L. SRY-negative 46,XX testicular/ovotesticular DSD: Long-term outcomes and early blockade of gonadotropic axis. Clin Endocrinol (Oxf) 2021; 94:667-676. [PMID: 33296530 DOI: 10.1111/cen.14389] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/19/2020] [Accepted: 11/22/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVE SRY-negative 46,XX testicular and ovotesticular disorders/differences of sex development (T/OTDSD) represent a very rare and unique DSD condition where testicular tissue develops in the absence of a Y chromosome. To date, very few studies have described the phenotype, clinical and surgical management and long-term outcomes of these patients. Particularly, early blockade of the gonadotropic axis in patients raised in the female gender to minimize postnatal androgenization has never been reported. DESIGN Retrospective description of sixteen 46,XX T/OTDSD patients. RESULTS Sixteen 46,XX SRY-negative T/OTDSD were included. Most (12/16) were diagnosed in the neonatal period. Sex of rearing was male for six patients and female for ten, while the clinical presentation varied, with an external masculinization score from 1 to 10. Five patients raised as girl were successfully treated with GnRH analog to avoid virilization during minipuberty. Ovotestes/testes were found bilaterally for 54% of the patients and unilaterally for the others (with a contralateral ovary). Gonadal surgery preserved appropriate tissue in the majority of cases. Spontaneous puberty occurred in two girls and one boy, while two boys required hormonal induction of puberty. One of the girls conceived spontaneously and had an uneventful pregnancy. DNA analyses (SNP-array, next-generation sequencing and whole-exome sequencing) were performed. A heterozygous frameshit mutation in the NR2F2 gene was identified in one patient. CONCLUSIONS This study presents a population of patients with 46,XX SRY-negative T/OTDSD. Early blockade of gonadotropic axis appears efficient to reduce and avoid further androgenization in patients raised as girls.
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Affiliation(s)
- Sophie Lambert
- Pediatric Endocrinology Department, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Robert Debré Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
- Pediatric Endocrinology Department, CHC, Liège, Belgium
- Pediatric Endocrinology Department, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium
| | - Matthieu Peycelon
- Pediatric Endocrinology Department, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Robert Debré Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
- Pediatric Surgery and Urology Department, Robert Debré Hospital, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Dinane Samara-Boustani
- Pediatric Endocrinology Department, CHU Necker-Enfants Malades, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Capucine Hyon
- INSERM, Maladies génétiques d'expression pédiatrique, APHP, Hôpital d'Enfants Armand Trousseau, Sorbonne Université, Paris, France
| | - Laurence Dumeige
- Pediatric Endocrinology Department, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Robert Debré Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
- INSERM UMR-S1185, Le Kremlin Bicêtre, France
| | - Michel Peuchmaur
- Université de Paris, Paris, France
- Pathology Department, Robert Debré Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Elodie Fiot
- Pediatric Endocrinology Department, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Robert Debré Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Juliane Léger
- Pediatric Endocrinology Department, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Robert Debré Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
- Université de Paris, Paris, France
- INSERM UMR 1141, DHU Protect, Paris, France
| | - Dominique Simon
- Pediatric Endocrinology Department, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Robert Debré Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Annabel Paye-Jaouen
- Pediatric Surgery and Urology Department, Robert Debré Hospital, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Jérome Bouligand
- Molecular Genetics and Hormonology Department, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, Le Kremlin Bicêtre, France
| | - Jean-Pierre Siffroi
- INSERM, Maladies génétiques d'expression pédiatrique, APHP, Hôpital d'Enfants Armand Trousseau, Sorbonne Université, Paris, France
| | - Jean-Claude Carel
- Pediatric Endocrinology Department, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Robert Debré Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
- Université de Paris, Paris, France
- INSERM UMR 1141, DHU Protect, Paris, France
| | - Ken McElreavey
- Department of Human Developmental Genetics, Institut Pasteur, Paris, France
| | - Alaa El Ghoneimi
- Pediatric Surgery and Urology Department, Robert Debré Hospital, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance publique-Hôpitaux de Paris, Paris, France
- Université de Paris, Paris, France
| | - Cécile Brachet
- Pediatric Endocrinology Department, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium
| | - Claire Bouvattier
- Pediatric Endocrinology Department, Bicêtre Hospital, Centre de Référence DEV-GEN, Paris-Saclay University, Kremlin Bicêtre, Paris, France
| | - Laetitia Martinerie
- Pediatric Endocrinology Department, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Robert Debré Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
- Université de Paris, Paris, France
- INSERM UMR-S1185, Le Kremlin Bicêtre, France
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Cambier A, Robert T, Hogan J, Rabant M, Peuchmaur M, Boyer O, Ulinski T, Monteiro RC, Mesnard L. Rare Collagenous Heterozygote Variants in Children With IgA Nephropathy. Kidney Int Rep 2021; 6:1326-1335. [PMID: 34013111 PMCID: PMC8116726 DOI: 10.1016/j.ekir.2021.02.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/05/2021] [Accepted: 02/08/2021] [Indexed: 01/15/2023] Open
Abstract
Introduction Childhood IgA nephropathy (cIgAN) is a primary glomerulonephritis clinically characterized by microscopic hematuria and proteinuria, the presence of which may potentially overlap with Alport syndrome. Interestingly, earlier studies suggested that familial IgAN could be linked to the chromosome 2q36 region, also the coding region for collagen type 4 alpha 3/4 (COL4A3/A4). Methods To investigate a possible relationship or phenocopy between Alport syndrome and cIgAN, COL4A3, COL4A4, and COL4A5 exons were sequenced in 36 cIgAN patients. Clinical data and treatment were collected retrospectively. COL4A3/A4/A5 variants were classified according to American College of Medical Genetics and the Association for Molecular Pathology (ACMG/AMP) guidelines. Results Four of 36 cIgAN patients were affected by ACMG class 4/5 COL4A3 heterozygous variants (COL4A3-cIgAN). We found no COL4A4 or COL4A5 variant. Despite having rare and deleterious COL4A3 variants, 3 of 4 COL4A3-cIgAN children developed clinical and biologic features of active IgAN rather than Alport syndrome. Response to intensive immunosuppressive treatment was favorable, leading to a reduction of endocapillary and extracapillary proliferation lesions. High levels of immune immunoglobulin G and A (IgG/IgA) complexes, reduction of proteinuria, and gradual stabilization of estimated glomerular filtration rate (eGFR) argued against Alport syndrome. Nevertheless, COL4A3-cIgAN patients seemed predisposed to a more serious IgAN presentation compared with the non‒COL4A3-cIgAN group, with more glomerulosclerosis and a lower eGFR over time. One of the 4 patients underwent kidney transplant with subsequent IgAN recurrence. Conclusions Predisposition factors for developing serious cIgAN flare-up should be considered for cIgAN with COL4A3 pathologic heterozygous variants. COL4A3 variants, usually responsible for Alport syndrome in adults, should not automatically exclude an immunosuppressive regimen in cIgAN. Moreover, evidence of an ACMG class 4/5 COL4A3 variant in early-stage cIgAN could be a helpful tool for stratifying severity of cIgAN beyond the Oxford classification.
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Affiliation(s)
- Alexandra Cambier
- Service de néphrologie pédiatrique, APHP, Hôpital Universitaire Robert-Debré, Paris, France.,Université de Paris, Paris, France; INSERM U1149; CNRS ERL8252; Centre de recherche sur l'inflammation; Inflamex Laboratory of Excellence, Paris, France.,Inserm UMR_S1155, Paris, France.,Sorbonne Université, Paris, France.,Néphrologie pédiatrique, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
| | - Thomas Robert
- Centre de néphrologie et transplantation rénale, APHM, Hôpital Universitaire de la Conception, Marseille, France.,Aix Marseille Université, Inserm, MMG, Bioinformatic et genetics.UMRS_1251, Paris, France
| | - Julien Hogan
- Service de néphrologie pédiatrique, APHP, Hôpital Universitaire Robert-Debré, Paris, France
| | - Marion Rabant
- Service de Pathologie, Hôpital Universitaire Hôpital Necker, APHP, Paris, France
| | - Michel Peuchmaur
- Service de Pathologie, Hôpital Universitaire Robert Debré APHP, Paris et Université Diderot, Paris, France
| | - Olivia Boyer
- Service de néphrologie pédiatrique, APHP, Hôpital Universitaire Necker, Paris, France
| | - Tim Ulinski
- Service de néphrologie pédiatrique, APHP, Hôpital Trousseau, Paris, France
| | - Renato C Monteiro
- Université de Paris, Paris, France; INSERM U1149; CNRS ERL8252; Centre de recherche sur l'inflammation; Inflamex Laboratory of Excellence, Paris, France
| | - Laurent Mesnard
- Inserm UMR_S1155, Paris, France.,Sorbonne Université, Paris, France.,Service des urgences néphrologiques et transplantation rénales, APHP, Hôpital Tenon, Paris, France.,Institut des Sciences du Calcul et des Données, Sorbonne Université, Paris, France
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6
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Cambier A, Rabant M, El Karoui K, Peuchmaur M, Servais A, Hertig A, Deschenes G, Salomon R, Hogan J, Robert T. Clinical and histological differences between adults and children in new onset IgA nephropathy. Pediatr Nephrol 2020; 35:1897-1905. [PMID: 32444925 DOI: 10.1007/s00467-020-04614-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 05/05/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Previous reports suggest initial presentation of IgA nephropathy (IgAN) in children is different from adults. No systematic comparison of clinical, biological, and histological childhood- and adult-onset IgAN is currently available. METHODS We compared pediatric and adult clinical and histological characteristics at IgAN diagnosis. Data on 211 consecutive patients from two different centers in Paris (82 children, 129 adults) were reviewed. Kidney biopsies were scored for Oxford classification and podocytopathic (P1) features. RESULTS We report higher eGFR at diagnosis in children compared to adults (89.5 vs. 64 ml/min/1.73 m2; p = 0.0001) but no difference in proteinuria. Histological analysis of kidney biopsy found higher proportions of mesangial (M1) and endocapillary (E1) hypercellularity in children compared with adults (M1 [80.7% vs. 27.9%, p = 0.0001]; E1 [71.3% vs. 30%, p = 0.0001]). Focal glomerulosclerosis (S1), tubular atrophy/interstitial fibrosis ≥ 25% (T1), and P1 were more frequent in adults (S1 [81.5% vs. 61.3%, p = 0.0012], T1 [49.5% vs. 1.35%, p = 0.0001], P1 [33.8% vs. 16.4%, p = 0.008). Proteinuria associated with M1, E1, and C1 in children (M1, p = 0.0001; E1, p = 0.0005; C1, p = 0.0014) but S1, P1, and T1 in adults (S1, p = 0.0001; P1, p = 0.0001; T1, p = 0.001). After steroid treatment (41 children and 28 adults), proteinuria decreased in children (p < 0.001, follow-up 38 months) and adults (p < 0.001, follow-up 76.9 months), whereas eGFR remained stable in adults but increased significantly in children (90.6 to 110 ml/min/1.73m2). CONCLUSION Proteinuria in children with IgAN is a marker of glomerular proliferative lesions whereas its presence in adults often reflects the presence of chronic lesions. This suggests the need for histological assessment.
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Affiliation(s)
- Alexandra Cambier
- Service de néphrologie pédiatrique, APHP, Hôpital Universitaire Robert-Debré, 48 Boulevard Serrurier, 75019, Paris, France.
| | - Marion Rabant
- Service de Pathologie, Hôpital Universitaire Hôpital Necker, APHP, Paris, France
| | - Khalil El Karoui
- Service de néphrologie et transplantation rénale, Hôpital Universitaire Henri-Mondor, Paris, France
| | - Michel Peuchmaur
- Service de Pathologie, Hôpital Universitaire Robert Debré APHP, Paris et Université Diderot, Paris, France
| | - Aude Servais
- Service de néphrologie et transplantation rénale, Hôpital Necker, APHP, Paris, France
| | - Alexandre Hertig
- Service des urgences néphrologiques et transplantation rénales, APHP, Hôpital Universitaire Tenon, Paris, France.,Université Pierre et Marie Curie Paris 6, Paris, France
| | - Georges Deschenes
- Service de néphrologie pédiatrique, APHP, Hôpital Universitaire Robert-Debré, 48 Boulevard Serrurier, 75019, Paris, France
| | - Remi Salomon
- Service de néphrologie pédiatrique, APHP, Hôpital Universitaire Necker, Paris, France
| | - Julien Hogan
- Service de néphrologie pédiatrique, APHP, Hôpital Universitaire Robert-Debré, 48 Boulevard Serrurier, 75019, Paris, France
| | - Thomas Robert
- Centre de néphrologie et transplantation rénale, APHM, Hôpital Universitaire de la Conception, 147 Bd Baille, 13385, Marseille, France.
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7
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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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8
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Delbet JD, Geslain G, Auger M, Hogan J, Salomon R, Peuchmaur M, Deschênes G, Buob D, Parmentier C, Ulinski T. Histological prognostic factors in children with Henoch-Schönlein purpura nephritis. Pediatr Nephrol 2020; 35:313-320. [PMID: 31696358 DOI: 10.1007/s00467-019-04363-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 07/29/2019] [Accepted: 09/06/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND The management of IgA vasculitis with nephritis (IgAVN) remains controversial because of the difficulty to identify prognostic factors. This study reports the prognosis of children with IgAVN in relation to histological parameters. METHODS All children with IgAVN diagnosed between 2000 and 2015 in three pediatric nephrology centers were included. The following histological parameters were analyzed: mesangial proliferation (MP), endocapillary proliferation (EP), crescents, active, or chronic tubular and interstitial lesions (TIa lesions/TIc lesions), and segmental glomerulosclerosis (GS). Clinical and biological data were collected at the time of renal biopsy. The primary endpoint was IgAVN remission defined as a proteinuria < 200 mg/l without renal failure. RESULTS One hundred fifty-nine children were included with a median age of 7.6 years. Acute glomerular or TI lesions including MP, EP, crescents, and TIa lesions were observed, respectively, in 81%, 86%, 49%, and 21% of patients. Chronic glomerular lesions including GS and TIc lesions were observed in 6 and 7% of patients. Median initial proteinuria was 330 mg/mmol, albuminemia 32 g/l, and eGFR 110 ml/min/1.73 m2. One hundred twelve (70%) patients were in remission at the end of a median follow-up of 37.4 months. Chronic lesions were significantly associated with the absence of remission in multivariate analysis, whereas EP, crescents and TIa were not associated with a poor prognosis. CONCLUSIONS Of children with IgAVN, 30% present a persistent renal disease at the end of a 3-year follow-up. Chronic histological lesions, but not EP or crescents, are associated with a bad prognosis and must be evaluated in IgAVN histological classification.
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Affiliation(s)
- Jean-Daniel Delbet
- Pediatric Nephrology unit, Trousseau Hospital, APHP.6, DMU Origyne, 26 Avenue du Docteur Arnold Netter, 75012, Paris, France. .,Sorbonne Université, Paris 6, Paris, France.
| | - Guillaume Geslain
- Pediatric Nephrology unit, Trousseau Hospital, APHP.6, DMU Origyne, 26 Avenue du Docteur Arnold Netter, 75012, Paris, France
| | - Martin Auger
- Pediatric Nephrology unit, Trousseau Hospital, APHP.6, DMU Origyne, 26 Avenue du Docteur Arnold Netter, 75012, Paris, France
| | - Julien Hogan
- Pediatric Nephrology, Robert Debré Hospital, APHP, Paris, France.,University Paris Diderot, Paris 7, Paris, France
| | - Rémi Salomon
- Pediatric Nephrology, Necker Enfants Malades, APHP, Paris, France
| | - Michel Peuchmaur
- Pediatric Nephrology, Robert Debré Hospital, APHP, Paris, France
| | - Georges Deschênes
- Pediatric Nephrology, Robert Debré Hospital, APHP, Paris, France.,University Paris Diderot, Paris 7, Paris, France
| | - David Buob
- Pathology Department, Tenon Hospital, APHP, Paris, France
| | - Cyrielle Parmentier
- Pediatric Nephrology unit, Trousseau Hospital, APHP.6, DMU Origyne, 26 Avenue du Docteur Arnold Netter, 75012, Paris, France
| | - Tim Ulinski
- Pediatric Nephrology unit, Trousseau Hospital, APHP.6, DMU Origyne, 26 Avenue du Docteur Arnold Netter, 75012, Paris, France.,Sorbonne Université, Paris 6, Paris, France
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9
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Nattes E, Karaa D, Dehoux L, Peuchmaur M, Kwon T, Deschênes G. Remission of proteinuria in multidrug-resistant idiopathic nephrotic syndrome following immunoglobulin immunoadsorption. Acta Paediatr 2019; 108:757-762. [PMID: 30230027 DOI: 10.1111/apa.14582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 09/13/2018] [Accepted: 09/14/2018] [Indexed: 12/20/2022]
Abstract
AIM Complete or partial resistance to prednisone and calcineurin inhibitors in children with idiopathic nephrotic syndrome often leads to end-stage renal disease. The aim of the study was to report the outcome of patients with multidrug-resistant nephrotic syndrome treated with an association of immunoglobulin immunoadsorption, intravenous immunoglobulins and B-cell depletion. METHODS At treatment initiation, patients received ten sessions of immunoglobulin immunoadsorption and intravenous immunoglobulins in two weeks followed by one rituximab in case of remission. RESULTS A remission of proteinuria was obtained in nine out of 14 patients at the end of the initial phase and in two additional patients after an extended period. The remission was stable in three patients and after additional IgIA and heavy immunosuppression in six. Two patients that initially responded relapsed after IgIA withdrawal and remained with an uncontrolled disease at last follow-up. Three patients did not respond to the treatment including two who were found to have a genetic podocytopathy. CONCLUSION Patients with multidrug-resistant idiopathic nephrotic syndrome can be successfully led into remission by IgIA prior to reaching end-stage renal disease. However, IgIA does not suppress the need for heavy additional immunosuppression to control INS in most cases.
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Affiliation(s)
- Elodie Nattes
- Pediatric Nephrology Unit; Hôpital Robert Debré; APHP; Sorbonne Paris Cité University; Paris France
| | - Danièle Karaa
- Pediatric Nephrology Unit; Hôpital Robert Debré; APHP; Sorbonne Paris Cité University; Paris France
| | - Laurène Dehoux
- Pediatric Nephrology Unit; Hôpital Robert Debré; APHP; Sorbonne Paris Cité University; Paris France
| | - Michel Peuchmaur
- Laboratory of Pathology; Hôpital Robert Debré; APHP; Sorbonne Paris Cité University; Paris France
| | - Theresa Kwon
- Pediatric Nephrology Unit; Hôpital Robert Debré; APHP; Sorbonne Paris Cité University; Paris France
| | - Georges Deschênes
- Pediatric Nephrology Unit; Hôpital Robert Debré; APHP; Sorbonne Paris Cité University; Paris France
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10
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Tournier L, Berrebi D, Peuchmaur M, Bonnard A, Belarbi N, Sibony O, Morcrette G. [Pulmonary glial heterotopia: Unique lesion in an infant with anencephalic twin]. Ann Pathol 2018; 39:24-28. [PMID: 30553644 DOI: 10.1016/j.annpat.2018.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/03/2018] [Accepted: 08/13/2018] [Indexed: 11/30/2022]
Abstract
Pulmonary glial heterotopia is an extremely rare entity whose pathophysiology remains unclear. We report for the first time one case of pulmonary glial heterotopia occured in a one-month baby free from any malformation. She has the particularity of being born from monozygotic monochorionic twin pregnancy where her anencephalic exencephalic sister suffered a medical termination of pregnancy. She presented neonatal respiratory distress, which recurred one month later. Chest X-ray revealed bilateral cystic pulmonary lesions mainly located in the right lung. Given the suspicion of congenital cystic adenomatoid malformation (CCAM), she underwent an upper and a lower right lung lobectomy at four months old. The pathological study found a multi-cystic lesion consisted of well-differentiated and poorly cellular glial tissue sometimes lined by bronchic epithelium. There was no pathological evidence for a CCAM. The evolution was favorable after surgery with an infant who was well five months later. This is one of the very few cases where the disease did not lead to rapid death in utero or during the perinatal period. This suggests that effective management by surgery could be a decisive factor in the survival of these patients.
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Affiliation(s)
- Louis Tournier
- Service de pathologie, hôpital universitaire Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France; Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France
| | - Dominique Berrebi
- Service de pathologie, hôpital universitaire Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France; Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France.
| | - Michel Peuchmaur
- Service de pathologie, hôpital universitaire Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France; Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France
| | - Arnaud Bonnard
- Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France; Service de chirurgie générale, hôpital universitaire Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France
| | - Nadia Belarbi
- Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France; Service de radiologie, hôpital universitaire Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France
| | - Olivier Sibony
- Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France; Service de gynécologie obstétrique, hôpital universitaire Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France
| | - Guillaume Morcrette
- Service de pathologie, hôpital universitaire Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France; Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France
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11
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Robert T, Cambier A, El Kharoui K, Servais A, Rabant M, Peuchmaur M, Hertig A, Deschenes G, Salomon R, Hogan J. Comparaison de la présentation clinique et histologique de la néphropathie à IgA entre les enfants et les adultes. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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12
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Terzic T, Cordeau M, Herblot S, Teira P, Cournoyer S, Beaunoyer M, Peuchmaur M, Duval M, Sartelet H. Expression of Disialoganglioside (GD2) in Neuroblastic Tumors: A Prognostic Value for Patients Treated With Anti-GD2 Immunotherapy. Pediatr Dev Pathol 2018; 21:355-362. [PMID: 29067879 DOI: 10.1177/1093526617723972] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Neuroblastoma, a malignant neoplasm of the sympathetic nervous system, is one of the most aggressive pediatric cancers. Patients with stage IV high-risk neuroblastoma receive an intensive multimodal therapy ending with an immunotherapy based on a chimeric monoclonal antibody ch14.18. Although the use of ch14.18 monoclonal antibody has significantly increased the survival rate of high-risk neuroblastoma patients, about 33% of these patients still relapse and die from their disease. Ch14.18 targets the disialoganglioside, GD2, expressed on neuroblastic tumor (NT) cells. To better understand the causes of tumor relapse following ch14.18 immunotherapy, we have analyzed the expression of GD2 in 152 tumor samples from patients with NTs using immunohistochemical stainings. We observed GD2 expression in 146 of 152 samples (96%); however, the proportion of GD2-positive cells varied among samples. Interestingly, low percentage of GD2-positive cells before immunotherapy was associated with relapse in patients receiving ch14.18 immunotherapy. In addition, we demonstrated in vitro that the sensitivity of neuroblastoma cell lines to natural killer-mediated lysis was dependent on the proportion of GD2-positive cells, in the presence of ch14.18 antibody. In conclusion, our results indicate that the proportion of tumor cells expressing GD2 in NTs should be taken in consideration, as a prognostic marker, for high-risk neuroblastoma patients receiving anti-GD2 immunotherapy.
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Affiliation(s)
- Tatjana Terzic
- 1 Research Center, Department of Pathology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
| | - Martine Cordeau
- 1 Research Center, Department of Pathology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
| | - Sabine Herblot
- 1 Research Center, Department of Pathology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
| | - Pierre Teira
- 2 Department of Oncology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
| | - Sonia Cournoyer
- 1 Research Center, Department of Pathology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
| | - Mona Beaunoyer
- 3 Department of Surgery, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
| | - Michel Peuchmaur
- 4 Department of Pathology, Centre Hospitalier Universitaire de Grenoble, Université Joseph Fourier, Grenoble, France
| | - Michel Duval
- 1 Research Center, Department of Pathology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
| | - Herve Sartelet
- 1 Research Center, Department of Pathology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada.,4 Department of Pathology, Centre Hospitalier Universitaire de Grenoble, Université Joseph Fourier, Grenoble, France
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13
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Saucier E, Hogan J, Peuchmaur M, Deschênes G, Baruchel A, Karava V. Nephrotic-range proteinuria and brown urine in an 8-year-old girl: Questions. Pediatr Nephrol 2018; 33:1001-1002. [PMID: 28921016 DOI: 10.1007/s00467-017-3795-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 08/08/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Emilie Saucier
- Pediatric Nephrology Department, Hôpital Universitaire Robert Debré, APHP, 48 Boulevard Sérurier, 75019, Paris, France
| | - Julien Hogan
- Pediatric Nephrology Department, Hôpital Universitaire Robert Debré, APHP, 48 Boulevard Sérurier, 75019, Paris, France
| | - Michel Peuchmaur
- Anatomical Pathology and Cytology Department, Hôpital Universitaire Robert Debré, APHP, 48 Boulevard Sérurier, 75019, Paris, France
| | - Georges Deschênes
- Pediatric Nephrology Department, Hôpital Universitaire Robert Debré, APHP, 48 Boulevard Sérurier, 75019, Paris, France
| | - Andre Baruchel
- Pediatric Hemato-oncology Department, Hôpital Universitaire Robert Debré, APHP, 48 Boulevard Sérurier, 75019, Paris, France
| | - Vasiliki Karava
- Pediatric Nephrology Department, Hôpital Universitaire Robert Debré, APHP, 48 Boulevard Sérurier, 75019, Paris, France.
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14
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Saucier E, Hogan J, Peuchmaur M, Deschênes G, Baruchel A, Karava V. Nephrotic-range proteinuria and brown urine in an 8-year-old girl: Answers. Pediatr Nephrol 2018; 33:1003-1005. [PMID: 28921340 DOI: 10.1007/s00467-017-3797-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 08/08/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Emilie Saucier
- Pediatric Nephrology Department, Hôpital Universitaire Robert Debré, APHP, 48 Boulevard Sérurier, 75019, Paris, France
| | - Julien Hogan
- Pediatric Nephrology Department, Hôpital Universitaire Robert Debré, APHP, 48 Boulevard Sérurier, 75019, Paris, France
| | - Michel Peuchmaur
- Anatomical Pathology and Cytology Department, Hôpital Universitaire Robert Debré, APHP, Paris, France
| | - Georges Deschênes
- Pediatric Nephrology Department, Hôpital Universitaire Robert Debré, APHP, 48 Boulevard Sérurier, 75019, Paris, France
| | - Andre Baruchel
- Pediatric Hemato-oncology Department, Hôpital Universitaire Robert Debré, APHP, Paris, France
| | - Vasiliki Karava
- Pediatric Nephrology Department, Hôpital Universitaire Robert Debré, APHP, 48 Boulevard Sérurier, 75019, Paris, France.
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15
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Cambier A, Rabant M, Peuchmaur M, Hertig A, Deschenes G, Couchoud C, Kolko A, Salomon R, Hogan J, Robert T. Immunosuppressive Treatment in Children With IgA Nephropathy and the Clinical Value of Podocytopathic Features. Kidney Int Rep 2018; 3:916-925. [PMID: 29988999 PMCID: PMC6035143 DOI: 10.1016/j.ekir.2018.03.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 02/27/2018] [Accepted: 03/22/2018] [Indexed: 11/25/2022] Open
Abstract
Introduction There is a need for treatment guidelines and prognostic factor identification in children with primary IgA nephropathy. We analyzed the causative effect of steroids and the applicability of the Oxford classification. Methods A total of 82 consecutive children (mean 10.6 years; median follow-up 3.3 years) were reviewed; 21 patients (25.6%) presented with acute kidney injury, and 6 (7.3%) with nephrotic syndrome. Renal biopsies were scored for Oxford classification and podocytopathic features in 2 groups: a group treated with steroid therapy (some in association with cyclophosphamide) and supportive care (renin angiotensin system blockade) and a group treated by supportive care alone. Results The 2 groups were not comparable because baseline clinical data were different. Estimated glomerular filtration rate (eGFR) in immunosupressive group significantly improved between M0 (at onset) and M6 (6 months after treatment) from 89.9 [61.2–114.5] to 110.5 [93.7–120] ml/min per 1.73 m2, P < 0.001. Proteinuria also significantly decreased from (1.6 [1–4.3] to 0.3 [0.2–0.7] g/g, P < 0.001). In the supportive care group, eGFR and proteinuria remained stable. Podocytopathic features were predictive of renal function decline by univariable (−4.9 ± 14.9 ml/min per 1.73 m2, P = 0.0079) and multivariable analysis and of poor renal prognosis to a combined event (renal function impairment more than 10% of the eGFR baseline or chronic kidney disease stage 3 at 6 months) in univariable analysis. MEST-C score failed to prove its prognostic value. Conclusion Immunosuppressive treatment, especially steroid therapy, seems beneficial in children with glomerular inflammation and proliferation. The Oxford classification does not appear to be entirely appropriate in predicting long-term renal prognosis for children, whereas the characteristics of podocytopathy are strongly predictive of renal prognosis.
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Affiliation(s)
- Alexandra Cambier
- Pediatric Department of Nephrology and Transplantation, APHP, Hôpital Robert-Debré, Paris, France
| | - Marion Rabant
- Service de Pathologie, Hôpital Universitaire Hôpital Necker APHP, Paris, France
| | - Michel Peuchmaur
- Service de Pathologie, Hôpital Universitaire Robert-Debré APHP, Paris et Université Diderot, Paris 7, France
| | - Alexandre Hertig
- Department of Nephrology, Transplantation and Emergency, APHP, Hôpital Tenon, Paris, France
- Université Pierre et Marie Curie Paris 6, Paris, France
| | - Georges Deschenes
- Pediatric Department of Nephrology and Transplantation, APHP, Hôpital Robert-Debré, Paris, France
| | - Cecile Couchoud
- Renal Epidemiology and Information Network Registry, Agence de la biomédecine, Saint-Denis la Plaine, France
| | | | - Remi Salomon
- Pediatric Department of Nephrology and Transplantation, APHP, Hôpital Necker, Paris, France
| | - Julien Hogan
- Pediatric Department of Nephrology and Transplantation, APHP, Hôpital Robert-Debré, Paris, France
| | - Thomas Robert
- Department of Nephrology, Transplantation and Emergency, APHP, Hôpital Tenon, Paris, France
- Université Pierre et Marie Curie Paris 6, Paris, France
- Department of Nephrology and Transplantation, APHM, Hôpital Universitaire de la Conception, Marseille, France
- Correspondence: Thomas Robert, Centre de néphrologie et transplantation rénale, APHM, Hôpital de la Conception, 147 Bd baille, 13385, Marseille, France.
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16
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Tordjman M, Ouachee M, Bonnard A, Tilea B, Yakouben K, Viala J, Peuchmaur M, Berrebi D. Small bowel stenosis: a manifestation of chronic graft-versus-host disease in children? Hum Pathol 2018; 72:174-179. [DOI: 10.1016/j.humpath.2017.08.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 08/23/2017] [Accepted: 08/25/2017] [Indexed: 02/07/2023]
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17
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Pons M, Leporq B, Ali L, Alison M, Albuquerque M, Peuchmaur M, Poli Mérol ML, Blank U, Lambert SA, El Ghoneimi A. Renal parenchyma impairment characterization in partial unilateral ureteral obstruction in mice with intravoxel incoherent motion-MRI. NMR Biomed 2018; 31:e3858. [PMID: 29178439 DOI: 10.1002/nbm.3858] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 08/19/2017] [Accepted: 10/11/2017] [Indexed: 06/07/2023]
Abstract
Ureteropelvic junction obstruction constitutes a major cause of progressive pediatric renal disease. The biological mechanisms underlying the renal response to obstruction can be investigated using a clinically relevant mouse model of partial unilateral ureteral obstruction (pUUO). Renal function and kidney morphology data can be evaluated using renal ultrasound, scintigraphy and uro-magnetic resonance imaging (uro-MRI), but these methods are poorly linked to histological change and not all are quantitative. Here, we propose to investigate pUUO for the first time using an intravoxel incoherent motion diffusion sequence. The aim of this study was to quantitatively characterize impairment of the kidney parenchyma in the pUUO model. This quantitative MRI method was able to assess the perfusion and microstructure of the kidney without requiring the injection of a contrast agent. The results suggest that a perfusion fraction (f) reduction is associated with a decrease in the volume of the renal parenchyma, which could be related to decreased renal vascularization. The latter may occur before impairment by fibrosis and the findings are in accordance with the literature using the UUO mice model and, more specifically, on pUUO. Further investigation is required before this technique can be made available for the diagnosis and management of children with antenatal hydronephrosis and to select the optimal timing of surgery if required.
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Affiliation(s)
- Maguelonne Pons
- INSERM UMR 1149, Paris, France
- CNRS ERL8252, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
| | - Benjamin Leporq
- INSERM UMR 1149, Paris, France
- CNRS ERL8252, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
- Université Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
| | - Liza Ali
- INSERM UMR 1149, Paris, France
- CNRS ERL8252, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
- Department of Pediatric Surgery and Urology, Hôpital Robert Debré, APHP, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Marianne Alison
- Department of Pediatric Radiology, Hôpital Robert Debré, APHP, Université Paris Diderot, PRES Sorbonne Paris-Cité, INSERM U1141, DHU PROTECT, Paris, France
| | | | - Michel Peuchmaur
- Department of Pathology, Hôpital Robert Debré, APHP, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | | | - Ulrich Blank
- INSERM UMR 1149, Paris, France
- CNRS ERL8252, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
| | - Simon A Lambert
- INSERM UMR 1149, Paris, France
- CNRS ERL8252, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
- Université Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
| | - Alaa El Ghoneimi
- INSERM UMR 1149, Paris, France
- CNRS ERL8252, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
- Department of Pediatric Surgery and Urology, Hôpital Robert Debré, APHP, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
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18
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Ben Youssef G, Tourret M, Salou M, Ghazarian L, Houdouin V, Mondot S, Mburu Y, Lambert M, Azarnoush S, Diana JS, Virlouvet AL, Peuchmaur M, Schmitz T, Dalle JH, Lantz O, Biran V, Caillat-Zucman S. Ontogeny of human mucosal-associated invariant T cells and related T cell subsets. J Exp Med 2018; 215:459-479. [PMID: 29339446 PMCID: PMC5789419 DOI: 10.1084/jem.20171739] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 10/27/2017] [Accepted: 12/06/2017] [Indexed: 12/31/2022] Open
Abstract
There are very few human MAIT cells in cord blood. Ben Youssef et al. show that they slowly expand during childhood and point to a critical role of the TCRαβ repertoire in determining their unique ability to recognize MR1-restricted microbial antigens. Mucosal-associated invariant T (MAIT) cells are semi-invariant Vα7.2+ CD161highCD4− T cells that recognize microbial riboflavin precursor derivatives such as 5-OP-RU presented by MR1. Human MAIT cells are abundant in adult blood, but there are very few in cord blood. We longitudinally studied Vα7.2+ CD161high T cell and related subset levels in infancy and after cord blood transplantation. We show that Vα7.2+ and Vα7.2− CD161high T cells are generated early during gestation and likely share a common prenatal developmental program. Among cord blood Vα7.2+ CD161high T cells, the minority recognizing MR1:5-OP-RU display a TRAV/TRBV repertoire very similar to adult MAIT cells. Within a few weeks of life, only the MR1:5-OP-RU reactive Vα7.2+ CD161high T cells acquire a memory phenotype. Only these cells expand to form the adult MAIT pool, diluting out other Vα7.2+ CD161high and Vα7.2− CD161high populations, in a process requiring at least 6 years to reach adult levels. Thus, the high clonal size of adult MAIT cells is antigen-driven and likely due to the fine specificity of the TCRαβ chains recognizing MR1-restricted microbial antigens.
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Affiliation(s)
- Ghada Ben Youssef
- Institut national de recherche médicale (INSERM) UMR1149, Center for Research on Inflammation, Paris Diderot University, Paris, France
| | - Marie Tourret
- Institut national de recherche médicale (INSERM) UMR1149, Center for Research on Inflammation, Paris Diderot University, Paris, France
| | - Marion Salou
- Institut Curie, PSL Research University, INSERM U932, Paris, France
| | - Liana Ghazarian
- Institut national de recherche médicale (INSERM) UMR1149, Center for Research on Inflammation, Paris Diderot University, Paris, France
| | - Véronique Houdouin
- Institut national de recherche médicale (INSERM) UMR1149, Center for Research on Inflammation, Paris Diderot University, Paris, France.,Service de Gastroentérologie et Pneumologie Pédiatrique, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Stanislas Mondot
- Institut Curie, PSL Research University, INSERM U932, Paris, France
| | - Yvonne Mburu
- Institut Curie, PSL Research University, INSERM U932, Paris, France
| | - Marion Lambert
- Institut national de recherche médicale (INSERM) UMR1149, Center for Research on Inflammation, Paris Diderot University, Paris, France
| | - Saba Azarnoush
- Institut national de recherche médicale (INSERM) UMR1149, Center for Research on Inflammation, Paris Diderot University, Paris, France
| | - Jean-Sébastien Diana
- Institut national de recherche médicale (INSERM) UMR1149, Center for Research on Inflammation, Paris Diderot University, Paris, France
| | - Anne-Laure Virlouvet
- Service de Pédiatrie et Réanimation Néonatale, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Michel Peuchmaur
- Institut national de recherche médicale (INSERM) UMR1149, Center for Research on Inflammation, Paris Diderot University, Paris, France.,Service de Pathologie Pédiatrique, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Thomas Schmitz
- Service d'Obstétrique, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-Hugues Dalle
- Institut national de recherche médicale (INSERM) UMR1149, Center for Research on Inflammation, Paris Diderot University, Paris, France.,Service d'Hématologie Pédiatrique, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Olivier Lantz
- Institut Curie, PSL Research University, INSERM U932, Paris, France.,Centre d'Investigations Cliniques CIC-BT1428 IGR/Curie, Paris, France.,Equipe labellisée de la Ligue de Lutte contre le Cancer, Institut Curie, Paris, France.,Département de Biopathologie, Institut Curie, Paris, France
| | - Valérie Biran
- Service de Pédiatrie et Réanimation Néonatale, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Sophie Caillat-Zucman
- Institut national de recherche médicale (INSERM) UMR1149, Center for Research on Inflammation, Paris Diderot University, Paris, France .,Laboratoire d'Immunologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
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19
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Rybak A, Maisin A, Peuchmaur M, Hogan J, Baudouin V, Ulinski T, Deschênes G, Niel O. Cytomegalovirus prophylaxis after kidney transplantation in children: Longer is better. Arch Pediatr 2017. [DOI: 10.1016/j.arcped.2017.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Chicard M, Colmet-Daage L, Clement N, Danzon A, Bohec M, Bernard V, Baulande S, Bellini A, Deveau P, Pierron G, Lapouble E, Janoueix-Lerosey I, Peuchmaur M, Corradini N, Defachelles AS, Valteau-Couanet D, Michon J, Combaret V, Delattre O, Schleiermacher G. Whole-Exome Sequencing of Cell-Free DNA Reveals Temporo-spatial Heterogeneity and Identifies Treatment-Resistant Clones in Neuroblastoma. Clin Cancer Res 2017; 24:939-949. [DOI: 10.1158/1078-0432.ccr-17-1586] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 10/06/2017] [Accepted: 11/21/2017] [Indexed: 11/16/2022]
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21
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Tordjman M, Sommet J, Rega A, Benkerrou M, Berrebi D, Peuchmaur M. [An unexplained fever]. Ann Pathol 2017; 37:495-498. [PMID: 29153389 DOI: 10.1016/j.annpat.2017.10.008] [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: 11/04/2016] [Revised: 07/10/2017] [Accepted: 10/10/2017] [Indexed: 11/18/2022]
Affiliation(s)
- Mickael Tordjman
- Service de pathologie, hôpital universitaire Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France.
| | - Julie Sommet
- Service de pédiatrie générale, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France
| | - Adelaide Rega
- Service d'imagerie médicale, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France
| | - Malika Benkerrou
- Service d'hématologie, centre de drépanocytose, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - Dominique Berrebi
- Service de pathologie, hôpital universitaire Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France; Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France
| | - Michel Peuchmaur
- Service de pathologie, hôpital universitaire Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France; Université Diderot Paris 7 - SPC, 16, rue Huchard, 75018 Paris, France
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22
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Clermidi P, Bellon M, Skhiri A, Jaby O, Vitoux C, Peuchmaur M, Bonnard A. Fast track pediatric thoracic surgery: Toward day-case surgery? J Pediatr Surg 2017; 52:1800-1805. [PMID: 28259381 DOI: 10.1016/j.jpedsurg.2017.02.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/16/2017] [Accepted: 02/01/2017] [Indexed: 12/01/2022]
Abstract
PURPOSE Thoracoscopic lung resection for congenital pulmonary airway malformation (CPAM) is a safe technique for children. Our purpose was to evaluate the feasibility of a fast-track protocol in such cases. METHODS From September 2007 to May 2016, 101 patients underwent a thoracoscopic pulmonary resection of which 83 for CPAM (lobectomy, wedge resection or sequestrectomy). We retrospectively reviewed the characteristics of surgical procedure, postoperative management and complications through three time periods (September 2007-December 2009: n=14, January 2010-March 2013: n=30, April 2013-May 2016: n=39) corresponding to management protocols modifications introducing fast-track pathways. RESULTS Through the 3 time periods, median postoperative hospital stay decreases (4, 3, 2days successively, P=0.02). In the third time period, 4 patients underwent surgery in day-case surgery. The overall and surgical complication rates, mainly related to air leakage, remain stable through the 3 time periods (14%, P=0.41 and 10%, P=0.52 respectively). Among the 13 patients without postoperative pleural drainage, one required secondary drainage after a partial resection of an emphysema. CONCLUSION Fast-track protocol for children undergoing uncomplicated thoracic surgery for CPAM seems feasible without extra morbidity. Selected patient undergoing thoracoscopic resection of the lung may benefit from the absence of pleural drainage and can be operated on in day-case surgery. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Pauline Clermidi
- Department of Pediatric Surgery, Robert Debré Hospital, AP-HP 48 boulevard Sérurier, 75019 Paris, France.
| | - Myriam Bellon
- Department of Pediatric Anesthesiology, Robert Debré Hospital, AP-HP 48 boulevard Sérurier, 75019 Paris, France.
| | - Alia Skhiri
- Department of Pediatric Anesthesiology, Robert Debré Hospital, AP-HP 48 boulevard Sérurier, 75019 Paris, France.
| | - Olivier Jaby
- Department of Pediatric Surgery, Creteil Intercommunal Hospital, Créteil 40 avenue de Verdun, 94000 Créteil, France.
| | - Christine Vitoux
- Pediatric Intensive Care Unit, Robert Debré Hospital, AP-HP 48 boulevard Sérurier, 75019 Paris, France.
| | - Michel Peuchmaur
- Department of Anatomopathology, Robert Debré Hospital, AP-HP 48 boulevard Sérurier, 75019 Paris, France.
| | - Arnaud Bonnard
- Department of Pediatric Surgery, Robert Debré Hospital, AP-HP 48 boulevard Sérurier, 75019 Paris, France.
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23
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Cambier A, Rabant M, Peuchmaur M, Hertig A, Couchoud C, Deschennes G, Salomon R, Hogan J, Robert T. Néphropathie à IgA de l’enfant et de l’adolescent : intérêt de la corticothérapie. Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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24
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Pons M, Ali L, Beghdadi W, Danelli L, Alison M, Madjène LC, Calvo J, Claver J, Vibhushan S, Åbrink M, Pejler G, Poli-Mérol ML, Peuchmaur M, El Ghoneimi A, Blank U. Mast Cells and MCPT4 Chymase Promote Renal Impairment after Partial Ureteral Obstruction. Front Immunol 2017; 8:450. [PMID: 28523000 PMCID: PMC5415561 DOI: 10.3389/fimmu.2017.00450] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 03/31/2017] [Indexed: 11/29/2022] Open
Abstract
Obstructive nephropathy constitutes a major cause of pediatric renal progressive disease. The mechanisms leading to disease progression are still poorly understood. Kidney fibrotic lesions are reproduced using a model of partial unilateral ureteral obstruction (pUUO) in newborn mice. Based on data showing significant mast cell (MC) infiltration in patients, we investigated the role of MC and murine MCPT4, a MC-released chymase, in pUUO using MC- (Wsh/sh), MCPT4-deficient (Mcpt4−/−), and wild-type (WT) mice. Measurement of kidney length and volume by magnetic resonance imaging (MRI) as well as postmortem kidney weight revealed hypotrophy of operated right kidneys (RKs) and compensatory hypertrophy of left kidneys. Differences between kidneys were major for WT, minimal for Wsh/sh, and intermediate for Mcpt4−/− mice. Fibrosis development was focal and increased only in WT-obstructed kidneys. No differences were noticed for local inflammatory responses, but serum CCL2 was significantly higher in WT versus Mcpt4−/− and Wsh/sh mice. Alpha-smooth muscle actin (αSMA) expression, a marker of epithelial–mesenchymal transition (EMT), was high in WT, minimal for Wsh/sh, and intermediate for Mcpt4−/− RK. Supernatants of activated MC induced αSMA in co-culture experiments with proximal tubular epithelial cells. Our results support a role of MC in EMT and parenchyma lesions after pUUO involving, at least partly, MCPT4 chymase. They confirm the importance of morphologic impairment evaluation by MRI in pUUO.
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Affiliation(s)
- Maguelonne Pons
- INSERM UMRS 1149, Paris, France.,CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France.,Department of Pediatric Surgery and Urology, Hôpital Robert Debré, APHP, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Liza Ali
- INSERM UMRS 1149, Paris, France.,CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France.,Department of Pediatric Surgery and Urology, Hôpital Robert Debré, APHP, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Walid Beghdadi
- INSERM UMRS 1149, Paris, France.,CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
| | - Luca Danelli
- CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
| | - Marianne Alison
- Department of Pediatric Radiology, Hôpital Robert Debré, APHP, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Lydia Celia Madjène
- INSERM UMRS 1149, Paris, France.,CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
| | - Jessica Calvo
- Department of Pathology, Hôpital Robert Debré, APHP, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Julien Claver
- INSERM UMRS 1149, Paris, France.,CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
| | - Shamila Vibhushan
- INSERM UMRS 1149, Paris, France.,CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
| | - Magnus Åbrink
- Section of Immunology, Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Gunnar Pejler
- Uppsala University, Department of Medical Biochemistry and Microbiology, Uppsala, Sweden.,Swedish University of Agricultural Sciences, Department of Anatomy, Physiology and Biochemistry, Uppsala, Sweden
| | - Marie-Laurence Poli-Mérol
- Pediatric Surgery Unit, American Memorial Hospital, Université Reims Champagne Ardennes, Reims, France
| | - Michel Peuchmaur
- Department of Pathology, Hôpital Robert Debré, APHP, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Alaa El Ghoneimi
- INSERM UMRS 1149, Paris, France.,CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France.,Department of Pediatric Surgery and Urology, Hôpital Robert Debré, APHP, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Ulrich Blank
- INSERM UMRS 1149, Paris, France.,CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
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25
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Gardair C, Bousquet G, de Bazelaire C, Lehmann-Che J, de Cremoux P, Tran Van Nhieu J, Battistella M, Sockeel M, Calvani J, Peuchmaur M, Molina T, Gervais J, Moenaert E, Pottier Y, Prévaut L, Sekri K, Bertheau P. [Results of the Massive Open Online Course (MOOC) on cancer diagnosis and evaluation of its impact on the perception of the pathology specialty]. Ann Pathol 2017; 37:144-150. [PMID: 28318775 DOI: 10.1016/j.annpat.2017.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 02/07/2017] [Indexed: 11/16/2022]
Abstract
The Massive Open Online Course (or MOOC) "Diagnostic Strategies Cancers", was hosted in autumn 2016 on the platform "France Université Numérique" and had two levels of learners: students in the field of health and biology and the general public. Of the 5285 learners in 81 different countries, 1237 (23%) were successfully certified. This MOOC was also integrated into the teaching program of medical students of Paris Diderot University and Paris 13 University. Using anonymous questionnaires before and after MOOC, it has been shown that pathology is less known than other medical specialties. Participation in this MOOC led to a marked improvement in participants' knowledge of the place and role of the pathologist in the diagnosis of cancers. Regarding the students who have followed the MOOC as part of their university course, their comments were very positive, but it is necessary to make substantial adjustments in the amounts and contents of the campus-based courses.
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Affiliation(s)
- Charlotte Gardair
- Université Paris Diderot, Sorbonne-Paris-Cité, 75013 Paris, France; Service d'anatomie et cytologie pathologiques, CHU Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Guilhem Bousquet
- Université Paris 13, Sorbonne-Paris-Cité, 93430 Villetaneuse, Seine-Saint-Denis, France; Service d'oncologie, CHU Avicenne, AP-HP, 93000 Bobigny, Seine-Saint-Denis, France
| | - Cédric de Bazelaire
- Université Paris Diderot, Sorbonne-Paris-Cité, 75013 Paris, France; Service de radiologie, CHU Saint-Louis, AP-HP, 75010 Paris, France
| | - Jaqueline Lehmann-Che
- Université Paris Diderot, Sorbonne-Paris-Cité, 75013 Paris, France; Unité d'oncologie moléculaire, CHU Saint-Louis, AP-HP, 75010 Paris, France
| | - Patricia de Cremoux
- Université Paris Diderot, Sorbonne-Paris-Cité, 75013 Paris, France; Unité d'oncologie moléculaire, CHU Saint-Louis, AP-HP, 75010 Paris, France
| | - Jeanne Tran Van Nhieu
- Université Paris-Est Créteil, 94000 Créteil, Val-de-Marne, France; Département de pathologie, CHU Henri-Mondor, AP-HP, 94000 Créteil, Val-de-Marne, France
| | - Maxime Battistella
- Université Paris Diderot, Sorbonne-Paris-Cité, 75013 Paris, France; Service d'anatomie et cytologie pathologiques, CHU Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Marie Sockeel
- Université Paris Diderot, Sorbonne-Paris-Cité, 75013 Paris, France; Service d'anatomie et cytologie pathologiques, CHU Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Julien Calvani
- Université Paris Diderot, Sorbonne-Paris-Cité, 75013 Paris, France; Service d'anatomie et cytologie pathologiques, CHU Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Michel Peuchmaur
- Université Paris Diderot, Sorbonne-Paris-Cité, 75013 Paris, France; Service de pathologie, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - Thierry Molina
- Université Paris Descartes, Sorbonne-Paris-Cité, 75006 Paris, France; Service de pathologie, hôpital Necker, AP-HP, 75015 Paris, France
| | - Jocelyne Gervais
- Université Paris Diderot, Sorbonne-Paris-Cité, 75013 Paris, France; MédiTICE, université Paris Diderot, Sorbonne-Paris-Cité, 75010 Paris, France
| | - Emilie Moenaert
- Université Paris Diderot, Sorbonne-Paris-Cité, 75013 Paris, France; MédiTICE, université Paris Diderot, Sorbonne-Paris-Cité, 75010 Paris, France
| | - Yohann Pottier
- Université Paris Diderot, Sorbonne-Paris-Cité, 75013 Paris, France; MédiTICE, université Paris Diderot, Sorbonne-Paris-Cité, 75010 Paris, France
| | - Laurent Prévaut
- Université Paris Diderot, Sorbonne-Paris-Cité, 75013 Paris, France; MédiTICE, université Paris Diderot, Sorbonne-Paris-Cité, 75010 Paris, France
| | - Karima Sekri
- Université Paris Diderot, Sorbonne-Paris-Cité, 75013 Paris, France; MédiTICE, université Paris Diderot, Sorbonne-Paris-Cité, 75010 Paris, France
| | - Philippe Bertheau
- Université Paris Diderot, Sorbonne-Paris-Cité, 75013 Paris, France; Service d'anatomie et cytologie pathologiques, CHU Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
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Niel O, Maisin A, Macher MA, Peuchmaur M, Deschênes G. Cinacalcet in hyperparathyroidism management after pediatric renal transplantation. CEN Case Rep 2016; 5:141-143. [PMID: 28508965 PMCID: PMC5413752 DOI: 10.1007/s13730-015-0211-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 12/25/2015] [Indexed: 11/27/2022] Open
Abstract
Secondary hyperparathyroidism is often associated with end stage renal disease; even after renal transplantation, hyperparathyroidism may persist, and is responsible for hypercalcemia, hypophosphatemia and elevated parathyroid hormone (iPTH) levels. Parathyroid hyperplasia is frequently associated with persistent hyperparathyroidism, and may require a surgical treatment. Here, we report hyperparathyroidism along with parathyroid hyperplasia in a 7-year-old child, which persisted after renal transplant. Calcitonin and pamidronate failed to decrease serum calcium levels; clodronate was also inefficient. Cinacalcet therapy normalized serum calcium and phosphorus levels, and decreased iPTH levels in 3 months; a severe parathyroid hyperplasia was also corrected under calcimimetic therapy. In conclusion, we report in a child that hypercalcemia associated with secondary hyperparathyroidism can be corrected with cinacalcet after pediatric renal transplantation. We also show that parathyroid hyperplasia can regress under calcimimetic therapy in a transplanted child, making surgery unnecessary.
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Affiliation(s)
- Olivier Niel
- Pediatric Nephrology Department, Robert Debré Hospital, 48 Boulevard Sérurier, 75019, Paris, France.
- Inserm U1163, Molecular Pathways of Hereditary Kidney Diseases, Imagine Institute, 24, Boulevard du Montparnasse, 75015, Paris, France.
| | - Anne Maisin
- Pediatric Nephrology Department, Robert Debré Hospital, 48 Boulevard Sérurier, 75019, Paris, France
| | - Marie-Alice Macher
- Pediatric Nephrology Department, Robert Debré Hospital, 48 Boulevard Sérurier, 75019, Paris, France
| | - Michel Peuchmaur
- Cytology and Pathology Department, Robert Debré Hospital, 48 Boulevard Sérurier, 75019, Paris, France
| | - Georges Deschênes
- Pediatric Nephrology Department, Robert Debré Hospital, 48 Boulevard Sérurier, 75019, Paris, France
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Chicard M, Boyault S, Colmet Daage L, Richer W, Gentien D, Pierron G, Lapouble E, Bellini A, Clement N, Iacono I, Bréjon S, Carrere M, Reyes C, Hocking T, Bernard V, Peuchmaur M, Corradini N, Faure-Conter C, Coze C, Plantaz D, Defachelles AS, Thebaud E, Gambart M, Millot F, Valteau-Couanet D, Michon J, Puisieux A, Delattre O, Combaret V, Schleiermacher G. Genomic Copy Number Profiling Using Circulating Free Tumor DNA Highlights Heterogeneity in Neuroblastoma. Clin Cancer Res 2016; 22:5564-5573. [DOI: 10.1158/1078-0432.ccr-16-0500] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 06/04/2016] [Accepted: 06/28/2016] [Indexed: 11/16/2022]
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Héritier S, Emile JF, Barkaoui MA, Thomas C, Fraitag S, Boudjemaa S, Renaud F, Moreau A, Peuchmaur M, Chassagne-Clément C, Dijoud F, Rigau V, Moshous D, Lambilliotte A, Mazingue F, Kebaili K, Miron J, Jeziorski E, Plat G, Aladjidi N, Ferster A, Pacquement H, Galambrun C, Brugières L, Leverger G, Mansuy L, Paillard C, Deville A, Armari-Alla C, Lutun A, Gillibert-Yvert M, Stephan JL, Cohen-Aubart F, Haroche J, Pellier I, Millot F, Lescoeur B, Gandemer V, Bodemer C, Lacave R, Hélias-Rodzewicz Z, Taly V, Geissmann F, Donadieu J. BRAF Mutation Correlates With High-Risk Langerhans Cell Histiocytosis and Increased Resistance to First-Line Therapy. J Clin Oncol 2016; 34:3023-30. [PMID: 27382093 DOI: 10.1200/jco.2015.65.9508] [Citation(s) in RCA: 198] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Langerhans cell histiocytosis (LCH) is an inflammatory myeloid neoplasia with a broad spectrum of clinical manifestations and outcomes in children. The somatic BRAF(V600E) mutation occurs frequently, but clinical significance remains to be determined. PATIENTS AND METHODS BRAF(V600E) mutation was investigated in a French LCH cohort. We analyzed associations between mutation status and clinical presentation, extent of disease, reactivation rate, response to therapy, and long-term permanent sequelae. RESULTS Among 315 patients with successfully determined BRAF status, 173 (54.6%) carried a BRAF(V600E) mutation. Patients with BRAF(V600E) manifested more severe disease than did those with wild-type BRAF. Patients with BRAF(V600E) comprised 87.8% of patients (43 of 49) with multisystem LCH with risk organ involvement (liver, spleen, hematology), 68.6% of patients (35 of 51) with multisystem LCH without risk organ involvement, 43.9% of patients (86 of 196) with single-system LCH, and 42.1% of patients (8 of 19) with lung-involved LCH (P < .001). BRAF(V600E) mutation was also associated with organ involvement that could lead to permanent, irreversible damage, such as neurologic (75%) and pituitary (72.9%) injuries. Compared with patients with wild-type BRAF, patients with BRAF(V600E) more commonly displayed resistance to combined vinblastine and corticosteroid therapy (21.9% v 3.3%; P = .001), showed a higher reactivation rate (5-year reactivation rate, 42.8% v 28.1%; P = .006), and had more permanent, long-term consequences from disease or treatment (27.9% v 12.6%; P = .001). CONCLUSION In children with LCH, BRAF(V600E) mutation was associated with high-risk features, permanent injury, and poor short-term response to chemotherapy. Further population-based studies should be undertaken to confirm our observations and to assess the impact of BRAF inhibitors for this subgroup of patients who may benefit from targeted therapy.
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Affiliation(s)
- Sébastien Héritier
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Jean-François Emile
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Mohamed-Aziz Barkaoui
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Caroline Thomas
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Sylvie Fraitag
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Sabah Boudjemaa
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Florence Renaud
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Anne Moreau
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Michel Peuchmaur
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Catherine Chassagne-Clément
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Frédérique Dijoud
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Valérie Rigau
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Despina Moshous
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Anne Lambilliotte
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Françoise Mazingue
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Kamila Kebaili
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Jean Miron
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Eric Jeziorski
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Geneviève Plat
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Nathalie Aladjidi
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Alina Ferster
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Hélène Pacquement
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Claire Galambrun
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Laurence Brugières
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Guy Leverger
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Ludovic Mansuy
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Catherine Paillard
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Anne Deville
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Corinne Armari-Alla
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Anne Lutun
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Marion Gillibert-Yvert
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Jean-Louis Stephan
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Fleur Cohen-Aubart
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Julien Haroche
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Isabelle Pellier
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Frédéric Millot
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Brigitte Lescoeur
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Virginie Gandemer
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Christine Bodemer
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Roger Lacave
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Zofia Hélias-Rodzewicz
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Valérie Taly
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Frédéric Geissmann
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
| | - Jean Donadieu
- Sébastien Héritier, Mohamed-Aziz Barkaoui, Jean Miron, and Jean Donadieu, French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital; Sébastien Héritier, Sabah Boudjemaa, Guy Leverger, and Jean Donadieu, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris; Sylvie Fraitag, Despina Moshous, and Christine Bodemer, Necker Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur and Brigitte Lescoeur, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris; Michel Peuchmaur, Université Paris Diderot, Sorbonne Paris Cité; Hélène Pacquement, Institut Curie Medical Center; Guy Leverger, Université Pierre et Marie Curie; Fleur Cohen-Aubart and Julien Haroche, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; Roger Lacave, Tenon Hospital, Assistance Publique-Hôpitaux de Paris; Valérie Taly, Institut National de la Santé et de la Recherche Médicale, Unités Mixte de Recherche S1147, Centre National de la Recherche Scientifique SNC 5014, Université Paris Sorbonne Cité, Paris; Sébastien Héritier, Jean-François Emile, Zofia Hélias-Rodzewicz, and Jean Donadieu, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay; Jean-François Emile, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt; Caroline Thomas and Anne Moreau, Centre Hospitalo-Universitaire de Nantes, Nantes; Florence Renaud, Centre Hospitalier Régional Universitaire, Université de Lille; Anne Lambilliotte and Françoise Mazingue, Centre Hospitalo-Universitaire de Lille, Lille; Catherine Chassagne-Clément, Centre Léon Bérard; Frédérique Dijoud, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon; Kamila Kebaili, Institut d'Hémato-Oncologie Pediatrique, Lyon; Valérie Rigau, Gui de Chauliac Hospital; Eric Jeziorski, Hôpital Arnaud de Villeneuve, Montpellier; Geneviève Plat, Centre Hospitalo-Universitaire de Toulouse, Toulouse; Nathalie Aladjidi, Centre Hospitalo-Universit
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Heide S, Masliah-Planchon J, Isidor B, Guimier A, Bodet D, Coze C, Deville A, Thebault E, Pasquier CJ, Cassagnau E, Pierron G, Clément N, Schleiermacher G, Amiel J, Delattre O, Peuchmaur M, Bourdeaut F. Oncologic Phenotype of Peripheral Neuroblastic Tumors Associated With PHOX2B Non-Polyalanine Repeat Expansion Mutations. Pediatr Blood Cancer 2016; 63:71-7. [PMID: 26375764 DOI: 10.1002/pbc.25723] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 08/03/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Germline non-polyalanine repeat expansion mutations in PHOX2B (PHOX2B NPARM) predispose to peripheral neuroblastic tumors (PNT), frequently in association with other neurocristopathies: Hirschsprung disease (HSCR) or congenital central hypoventilation syndrome (CCHS). Although PHOX2B polyalanine repeat expansions predispose to a low incidence of benign PNTs, the oncologic phenotype associated with PHOX2B NPARM is still not known in detail. METHODS We analyzed prognostic factors, treatment toxicity, and outcome of patients with PNT and PHOX2B NPARM. RESULTS Thirteen patients were identified, six of whom also had CCHS and/or HSCR, one also had late-onset hypoventilation with hypothalamic dysfunction (LO-CHS/HD), and six had no other neurocristopathy. Four tumours were "poorly differentiated," and nine were differentiated, including five ganglioneuromas, three ganglioneuroblastomas, and one differentiating neuroblastoma, hence illustrating that PHOX2B NPARM are predominantly associated with differentiating tumors. Nevertheless, three patients had stage 4 and one patient had stage 3 disease. Segmental chromosomal alterations, correlating with poor prognosis, were found in all the six tumors analyzed by array-comparative genomic hybridization. One patient died of tumor progression, one is on palliative care, one died of hypoventilation, and 10 patients are still alive, with median follow-up of 5 years. CONCLUSIONS Based on histological phenotype, our series suggests that heterozygous PHOX2B NPARM do not fully preclude ganglion cell differentiation in tumors. However, this tumor predisposition syndrome may also be associated with poorly differentiated tumors with unfavorable genomic profiles and clinically aggressive behaviors. The intrafamilial variability and the unpredictable tumor prognosis should be considered in genetic counseling.
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Affiliation(s)
- Solveig Heide
- Service de Pathologie, Hôpital Robert Debré, APHP, Paris, France
| | - Julien Masliah-Planchon
- INSERM U830, Génétique et Biologie des Cancers, Institut Curie, Paris, France.,Institut Curie, Unité de Génétique Somatique, Institut Curie, Paris, France
| | - Bertrand Isidor
- Service de Génétique Clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Anne Guimier
- INSERM UMR 1163, Institut Imagine, Paris, France
| | - Damien Bodet
- Unité d'Onco-Hématologie, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Carole Coze
- Service d'Oncologie Pédiatrique, Hôpital de la Timone, Centre Hospitalier Universitaire de Marseille, Marseille, France
| | - Anne Deville
- Service d'Onco-Hématologie Pédiatrique, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Estelle Thebault
- Service d'Onco-Hématologie Pédiatrique, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | | | - Elisabeth Cassagnau
- Service d'Anatomie Et Cytologie Pathologiques, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Gaelle Pierron
- Institut Curie, Unité de Génétique Somatique, Institut Curie, Paris, France
| | - Nathalie Clément
- Institut Curie, Unité de Génétique Somatique, Institut Curie, Paris, France
| | - Gudrun Schleiermacher
- INSERM U830, Génétique et Biologie des Cancers, Institut Curie, Paris, France.,Institut Curie, Unité de Génétique Somatique, Institut Curie, Paris, France
| | - Jeanne Amiel
- INSERM UMR 1163, Institut Imagine, Paris, France.,Sorbonne Paris Cite, Université Paris Descartes, Paris, France.,Service de Génétique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Olivier Delattre
- INSERM U830, Génétique et Biologie des Cancers, Institut Curie, Paris, France.,Institut Curie, Unité de Génétique Somatique, Institut Curie, Paris, France
| | - Michel Peuchmaur
- Service de Pathologie, Hôpital Robert Debré, APHP, Paris, France.,Sorbonne Paris Cite, Université Paris Diderot, Paris, France
| | - Franck Bourdeaut
- INSERM U830, Génétique et Biologie des Cancers, Institut Curie, Paris, France.,Institut Curie, Département de pédiatrie-adolescent-jeunes adultes, Institut Curie, Paris, France.,Site de Recherche Intégrée en Cancérologie, Recherche Translationnelle en Oncologie Pédiatrique, Institut Curie, Paris, France
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Hogan J, Fila M, Baudouin V, Peuchmaur M, Deschênes G, Niel O. Cytomegalovirus infection can mimic genetic nephrotic syndrome: a case report. BMC Nephrol 2015; 16:156. [PMID: 26395882 PMCID: PMC4580224 DOI: 10.1186/s12882-015-0152-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 09/17/2015] [Indexed: 11/26/2022] Open
Abstract
Background Nephrotic syndrome is a relatively rare but serious condition in children. Infantile nephrotic syndrome often has a genetic origin; the treatment is then symptomatic, with a poor prognosis, and a rapid evolution to chronic kidney disease. However, non-genetic infantile nephrotic syndrome has been identified. Here we report for the first time in a child a nephrotic syndrome as the sole clinical expression of a cytomegalovirus infection. Case presentation The patient was 5 months old when he presented with a nephrotic syndrome. An exhaustive genetic testing was conducted and came back negative. A viral work-up only showed a positive cytomegalovirus PCR. Antiviral treatment lead to a complete remission of the nephrotic syndrome, with no requirement for steroid therapy. Renal function remained normal throughout follow-up. Conclusion Nephrotic syndrome should always be carefully investigated in children. This observation reinforces the connection between viral infections and pediatric nephrotic syndrome, sparking more controversy about an infectious origin to childhood nephrotic disease.
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Affiliation(s)
- Julien Hogan
- Pediatric Nephrology Department, Robert Debré Hospital, 48 boulevard Sérurier, 75019, Paris, France.
| | - Marc Fila
- Pediatric Nephrology Department, Robert Debré Hospital, 48 boulevard Sérurier, 75019, Paris, France.
| | - Véronique Baudouin
- Pediatric Nephrology Department, Robert Debré Hospital, 48 boulevard Sérurier, 75019, Paris, France.
| | - Michel Peuchmaur
- Cytology and Pathology Department, Robert Debré Hospital, 48 boulevard Sérurier, 75019, Paris, France.
| | - Georges Deschênes
- Pediatric Nephrology Department, Robert Debré Hospital, 48 boulevard Sérurier, 75019, Paris, France.
| | - Olivier Niel
- Pediatric Nephrology Department, Robert Debré Hospital, 48 boulevard Sérurier, 75019, Paris, France. .,Inserm U1163, Molecular Pathways of Hereditary Kidney Diseases, Imagine Institute, 24, boulevard du Montparnasse, 75015, Paris, France.
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31
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Levy M, Bourrat E, Baudouin V, Guillem C, Peuchmaur M, Deschênes G, Fila M. Toxocara canis infection: Unusual trigger of systemic lupus erythematosus. Pediatr Int 2015; 57:785-8. [PMID: 26147636 DOI: 10.1111/ped.12646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 11/25/2014] [Accepted: 01/08/2015] [Indexed: 11/28/2022]
Abstract
Infection by Toxocara canis can cause systemic vasculitis. We report here a unique case of systemic lupus erythematosus (SLE) triggered by T. canis infection. An 8-year-old girl was treated with albendazole therapy for common toxocariasis, but she developed two weeks later, asthenia, fever, infiltrated maculopapular eruption of the face, peripheral vascular disease with necrosis of the fingers and inflammatory anemia with proteinuria. Anti-nuclear, anti-DNA and anti-Sm antibodies positivity, together with minimal change nephritis with mesangial exclusive IgM deposit on renal biopsy and clinical relapse after initially successful steroid therapy, led to the diagnosis of SLE. T. canis infection can trigger systemic lupus but must also be ruled out of the differential diagnosis given its association with autoimmunity.
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Affiliation(s)
| | - Emmanuelle Bourrat
- Dermatology Department, Saint-Louis University Hospital, Paris, France, Assistance Publique Hôpitaux de Paris
| | | | - Colette Guillem
- Pediatric Department, Mantes-la-Jolie Hospital, Mantes-la-Jolie, France
| | - Michel Peuchmaur
- Anatomopathology Department, Robert-Debré University Hospital, Paris, France
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32
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Héritier S, Emile JF, Barkaoui M, Moreau A, Rigau V, Dijoud F, Chassagne C, Charlotte F, Mokhtari K, Boudjemaa S, Coulomb A, Peuchmaur M, Copin MC, Fraitag S, Molina T, Jeziorski E, Thomas C, de Menthon M, Haroche J, Donadieu J. Langerhans cell histiocytosis in children: Correlation of BRAF status with clinical characteristic. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.10003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Valerie Rigau
- Pathological Department CHU Montpellier, Montpellier, France
| | | | | | | | | | | | - Aurore Coulomb
- Department of Pathology, Hopitaux Universitaires Est Parisien, Paris, France
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33
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Montavon G, Jauquier N, Coulon A, Peuchmaur M, Flahaut M, Bourloud KB, Yan P, Delattre O, Sommer L, Joseph JM, Janoueix-Lerosey I, Gross N, Mühlethaler-Mottet A. Wild-type ALK and activating ALK-R1275Q and ALK-F1174L mutations upregulate Myc and initiate tumor formation in murine neural crest progenitor cells. Oncotarget 2015; 5:4452-66. [PMID: 24947326 PMCID: PMC4147337 DOI: 10.18632/oncotarget.2036] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The anaplastic lymphoma kinase (ALK) gene is overexpressed, mutated or amplified in most neuroblastoma (NB), a pediatric neural crest-derived embryonal tumor. The two most frequent mutations, ALK-F1174L and ALK-R1275Q, contribute to NB tumorigenesis in mouse models, and cooperate with MYCN in the oncogenic process. However, the precise role of activating ALK mutations or ALK-wt overexpression in NB tumor initiation needs further clarification. Human ALK-wt, ALK-F1174L, or ALK-R1275Q were stably expressed in murine neural crest progenitor cells (NCPC), MONC-1 or JoMa1, immortalized with v-Myc or Tamoxifen-inducible Myc-ERT, respectively. While orthotopic implantations of MONC-1 parental cells in nude mice generated various tumor types, such as NB, osteo/chondrosarcoma, and undifferentiated tumors, due to v-Myc oncogenic activity, MONC-1-ALK-F1174L cells only produced undifferentiated tumors. Furthermore, our data represent the first demonstration of ALK-wt transforming capacity, as ALK-wt expression in JoMa1 cells, likewise ALK-F1174L, or ALK-R1275Q, in absence of exogenous Myc-ERT activity, was sufficient to induce the formation of aggressive and undifferentiated neural crest cell-derived tumors, but not to drive NB development. Interestingly, JoMa1-ALK tumors and their derived cell lines upregulated Myc endogenous expression, resulting from ALK activation, and both ALK and Myc activities were necessary to confer tumorigenic properties on tumor-derived JoMa1 cells in vitro.
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34
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Malric A, Defachelles AS, Leblanc T, Lescoeur B, Lacour B, Peuchmaur M, Maurage CA, Pierron G, Guillemot D, d'Enghien CD, Soulier J, Stoppa-Lyonnet D, Bourdeaut F. Fanconi anemia and solid malignancies in childhood: a national retrospective study. Pediatr Blood Cancer 2015; 62:463-70. [PMID: 25381700 DOI: 10.1002/pbc.25303] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 09/12/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Fanconi anemia (FA) predisposes to hematologic disorders and myeloid neoplasia in childhood and to solid cancers, mainly oral carcinomas, in early adulthood. Few cases of solid cancers have been reported in childhood. PROCEDURES We conducted a national retrospective study of solid tumors occurring in patients registered with or determined to have FA during childhood in France. Phenotypic features, tumor type, cancer treatment, and outcome were analyzed. Whenever available, fresh-frozen tumors were analyzed by microarray-based comparative genomics hybridization. RESULTS We identified eight patients with FA with solid tumor from 1986 to 2012. For two patients, the diagnosis of FA was unknown at the time of cancer diagnosis. Moreover, we identified one fetus with a brain tumor. All patients showed failure to thrive and had dysmorphic features and abnormal skin pigmentation. Seven patients had BRCA2/FANCD1 mutations; five of these featured more than one malignancy and the median age at the time of cancer diagnosis was 11 months (range 0.4-3 years). Solid tumor types included five nephroblastomas, two rhabdomyosarcomas, two neuroblastomas, and three brain tumors. Two children died from the toxic effects of chemotherapy, two patients from the cancer, and one patient from secondary leukemia. Only one BRCA2 patient was alive more than 3 years after diagnosis, after tailored chemotherapy. CONCLUSION Solid tumors are rare in FA during childhood, except in patients with BRCA2/FANCD1 mutations. The proper genetic diagnosis is mandatory to tailor the treatment.
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Affiliation(s)
- Aurore Malric
- Department of Pediatrics, Curie Institute, Paris, France
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35
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Cazes A, Lopez-Delisle L, Tsarovina K, Pierre-Eugène C, De Preter K, Peuchmaur M, Nicolas A, Provost C, Louis-Brennetot C, Daveau R, Kumps C, Cascone I, Schleiermacher G, Prignon A, Speleman F, Rohrer H, Delattre O, Janoueix-Lerosey I. Activated Alk triggers prolonged neurogenesis and Ret upregulation providing a therapeutic target in ALK-mutated neuroblastoma. Oncotarget 2015; 5:2688-702. [PMID: 24811913 PMCID: PMC4058037 DOI: 10.18632/oncotarget.1883] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Activating mutations of the ALK (Anaplastic lymphoma Kinase) gene have been identified in sporadic and familial cases of neuroblastoma, a cancer of early childhood arising from the sympathetic nervous system (SNS). To decipher ALK function in neuroblastoma predisposition and oncogenesis, we have characterized knock-in (KI) mice bearing the two most frequent mutations observed in neuroblastoma patients. A dramatic enlargement of sympathetic ganglia is observed in AlkF1178L mice from embryonic to adult stages associated with an increased proliferation of sympathetic neuroblasts from E14.5 to birth. In a MYCN transgenic context, the F1178L mutation displays a higher oncogenic potential than the R1279Q mutation as evident from a shorter latency of tumor onset. We show that tumors expressing the R1279Q mutation are sensitive to ALK inhibition upon crizotinib treatment. Furthermore, our data provide evidence that activated ALK triggers RET upregulation in mouse sympathetic ganglia at birth as well as in murine and human neuroblastoma. Using vandetanib, we show that RET inhibition strongly impairs tumor growth in vivo in both MYCN/KI AlkR1279Q and MYCN/KI AlkF1178L mice. Altogether, our findings demonstrate the critical role of activated ALK in SNS development and pathogenesis and identify RET as a therapeutic target in ALK mutated neuroblastoma.
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Affiliation(s)
- Alex Cazes
- Inserm U830, 26 rue d'Ulm, 75005 Paris, France
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36
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Monteiro RC, Beghdadi W, Madjene LC, Pons M, Peuchmaur M, Blank U. The function of mast cells in autoimmune glomerulonephritis. Methods Mol Biol 2015; 1220:487-496. [PMID: 25388269 DOI: 10.1007/978-1-4939-1568-2_29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Immune-mediated glomerulonephritis is caused by deposition of immune complexes on the glomerular basement membrane or of autoantibodies directed against the glomerular basement membrane. Depositions lead to an inflammatory response that can ultimately destroy renal function and lead to chronic kidney disease. However, the pathological processes leading to the development of renal injury and disease progression remain poorly understood. To investigate the mechanisms of disease development in glomerulonephritis various animal models have been developed, which include as the most popular one the induction of glomerulonephritis by the injection of heterologous antibodies directed to the glomerular basement membrane. The role of mast cells and mast cell-derived mediators has been evaluated in these models. In this chapter we describe the methods that allow to set up and study the disease parameters of immune-mediated glomerulonephritis development.
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Schleiermacher G, Javanmardi N, Bernard V, Leroy Q, Cappo J, Rio Frio T, Pierron G, Lapouble E, Combaret V, Speleman F, de Wilde B, Djos A, Øra I, Hedborg F, Träger C, Holmqvist BM, Abrahamsson J, Peuchmaur M, Michon J, Janoueix-Lerosey I, Kogner P, Delattre O, Martinsson T. Emergence of New ALK Mutations at Relapse of Neuroblastoma. J Clin Oncol 2014; 32:2727-34. [DOI: 10.1200/jco.2013.54.0674] [Citation(s) in RCA: 133] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose In neuroblastoma, the ALK receptor tyrosine kinase is activated by point mutations. We investigated the potential role of ALK mutations in neuroblastoma clonal evolution. Methods We analyzed ALK mutations in 54 paired diagnosis–relapse neuroblastoma samples using Sanger sequencing. When an ALK mutation was observed in one paired sample, a minor mutated component in the other sample was searched for by more than 100,000× deep sequencing of the relevant hotspot, with a sensitivity of 0.17%. Results All nine ALK-mutated cases at diagnosis demonstrated the same mutation at relapse, in one case in only one of several relapse nodules. In five additional cases, the mutation seemed to be relapse specific, four of which were investigated by deep sequencing. In two cases, no mutation evidence was observed at diagnosis. In one case, the mutation was present at a subclonal level (0.798%) at diagnosis, whereas in another case, two different mutations resulting in identical amino acid changes were detected, one only at diagnosis and the other only at relapse. Further evidence of clonal evolution of ALK-mutated cells was provided by establishment of a fully ALK-mutated cell line from a primary sample with an ALK-mutated cell population at subclonal level (6.6%). Conclusion In neuroblastoma, subclonal ALK mutations can be present at diagnosis with subsequent clonal expansion at relapse. Given the potential of ALK-targeted therapy, the significant spatiotemporal variation of ALK mutations is of utmost importance, highlighting the potential of deep sequencing for detection of subclonal mutations with a sensitivity 100-fold that of Sanger sequencing and the importance of serial samplings for therapeutic decisions.
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Affiliation(s)
- Gudrun Schleiermacher
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Niloufar Javanmardi
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Virginie Bernard
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Quentin Leroy
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Julie Cappo
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Thomas Rio Frio
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Gaelle Pierron
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Eve Lapouble
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Valérie Combaret
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Frank Speleman
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Bram de Wilde
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Anna Djos
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Ingrid Øra
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Fredrik Hedborg
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Catarina Träger
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Britt-Marie Holmqvist
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Jonas Abrahamsson
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Michel Peuchmaur
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Jean Michon
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Isabelle Janoueix-Lerosey
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Per Kogner
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Olivier Delattre
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
| | - Tommy Martinsson
- Gudrun Schleiermacher, Julie Cappo, Isabelle Janoueix-Lerosey, and Olivier Delattre, L'Institut National de la Santé et de la Recherche Médicale U830, Laboratoire de Génétique et Biologie des Cancers; Gudrun Schleiermacher, Virginie Bernard, Quentin Leroy, Thomas Rio Frio, Gaelle Pierron, Eve Lapouble, and Jean Michon, Institut Curie; Michel Peuchmaur, Assistance Publique–Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service de Pathologie; Michel Peuchmaur, Université Diderot Paris 7, Sorbonne
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Defachelles AS, Clément N, Duban-Bedu B, Boidein F, Pierron G, Ferrand S, Peuchmaur M, Delattre O, Bourdeaut F, Schleiermacher G. Case Report of a Patient With Speech Delay and Behavioral Disorders Associated with Neuroblastoma. Possible Role of SMARCA4. Cancer Genet 2014. [DOI: 10.1016/j.cancergen.2014.09.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Guinard-Samuel V, Bonnard A, Peuchmaur M, Berrebi D. A variant pattern of calretinin immunohistochemistry on rectal suction-biopsies is fully specific of short-segment Hirschsprung's disease. Pediatr Surg Int 2014; 30:803-8. [PMID: 24946949 DOI: 10.1007/s00383-014-3526-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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] [Accepted: 06/11/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND/PURPOSE Calretinin immunohistochemistry is now widely used to diagnose Hirschsprung's disease (HD), since loss of calretinin expression within the mucosa and muscularis mucosae of rectal suction-biopsy is pathognomonic of HD. However, a stippled staining may be observed within hypertrophic nerves in the submucosae in some HD patients. The aim of the study was to test the hypothesis that such findings may announce the beginning of the transitional zone. METHODS We retrieved 44 consecutive patients (10 girls and 34 boys; median age 6.5 days), diagnosed with aganglionosis on rectal suction biopsies, followed by surgery. According to calretinin immunohistochemistry performed on all paraffin-embedded rectal biopsies, we defined two HD groups: P- showing an absence of any staining within mucosa, muscularis mucosae and submucosa et P+ showing an absence of staining within the mucosa and muscularis mucosae, but a positivity of some submucosal hypertrophic nerves. These data were correlated to the length of total pathological segment (aganglionic and transitional zones) obtained from the original surgery reports. RESULTS 18/44 patients (40.9 %) belonged to the P+ group and 26/44 (59 %) patients were within the P- group. In the P+ group, the maximal length of the aganglionic zone was 9 cm [mean 4 (1-9)] and the total pathological zone never exceeded 14 cm [mean 8 (3.8-14)]. In the P- group, the maximal length of aganglionic zone was 55.5 cm [mean 11.3 (2.5; 55.5)] and the total pathological zone extended to 59.5 cm [mean 17.75 (4.5; 59.5)]. Aganglionic segment was significantly shorter in the P+ group (p < 0.0001). CONCLUSION Staining of some hypertrophic nerves in the submucosa in suction rectal biopsy of HD patients using calretinin immunohistochemistry is only encountered in short-segment aganglionosis with a pathological zone always restricted to rectal and sigmoid colon. This information could be crucial for the surgeons in the decision to choose a transanal procedure.
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Affiliation(s)
- Vincent Guinard-Samuel
- Pathology Department, Robert Debré Hospital, 48 Boulevard Sérurier, 75019, Paris, France,
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Guimier A, Ferrand S, Pierron G, Couturier J, Janoueix-Lerosey I, Combaret V, Mosseri V, Thebaud E, Gambart M, Plantaz D, Marabelle A, Coze C, Rialland X, Fasola S, Lapouble E, Fréneaux P, Peuchmaur M, Michon J, Delattre O, Schleiermacher G. Clinical characteristics and outcome of patients with neuroblastoma presenting genomic amplification of loci other than MYCN. PLoS One 2014; 9:e101990. [PMID: 25013904 PMCID: PMC4094484 DOI: 10.1371/journal.pone.0101990] [Citation(s) in RCA: 15] [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: 03/07/2014] [Accepted: 06/13/2014] [Indexed: 01/01/2023] Open
Abstract
Background Somatically acquired genomic alterations with MYCN amplification (MNA) are key features of neuroblastoma (NB), the most common extra-cranial malignant tumour of childhood. Little is known about the frequency, clinical characteristics and outcome of NBs harbouring genomic amplification(s) distinct from MYCN. Methods Genomic profiles of 1100 NBs from French centres studied by array-CGH were re-examined specifically to identify regional amplifications. Patients were included if amplifications distinct from the MYCN locus were seen. A subset of NBs treated at Institut Curie and harbouring MNA as determined by array-CGH without other amplification was also studied. Clinical and histology data were retrospectively collected. Results In total, 56 patients were included and categorised into 3 groups. Group 1 (n = 8) presented regional amplification(s) without MNA. Locus 12q13-14 was a recurrent amplified region (4/8 cases). This group was heterogeneous in terms of INSS stages, primary localisations and histology, with atypical clinical features. Group 2 (n = 26) had MNA as well as other regional amplifications. These patients shared clinical features of those of a group of NBs MYCN amplified (Group 3, n = 22). Overall survival for group 1 was better than that of groups 2 and 3 (5 year OS: 87.5%±11% vs 34.9%±7%, log-rank p<0.05). Conclusion NBs harbouring regional amplification(s) without MNA are rare and seem to show atypical features in clinical presentation and genomic profile. Further high resolution genetic explorations are justified in this heterogeneous group, especially when considering these alterations as predictive markers for targeted therapy.
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Affiliation(s)
- Anne Guimier
- Institut Curie, Département de Pédiatrie, Paris, France
| | | | - Gaëlle Pierron
- Institut Curie, Unité de Génétique Somatique, Paris, France
| | | | | | - Valérie Combaret
- Centre Léon Bérard, Laboratoire de recherche translationnelle, Lyon, France
| | | | - Estelle Thebaud
- CHU Nantes, Service d'Hémato-Oncologie Pédiatrique, Nantes, France
| | - Marion Gambart
- CHU Toulouse, Service d'Hémato-Oncologie Pédiatrique, Toulouse, France
| | - Dominique Plantaz
- CHU Grenoble, Service d'Hémato-Oncologie Pédiatrique, Grenoble, France
| | - Aurélien Marabelle
- Institut d'Hématologie et d'Oncologie Pédiatrique, Centre de Lutte contre le Cancer Léon Bérard, Lyon, France
| | - Carole Coze
- Aix-Marseille Univ et APHM, Hôpital d'Enfants de La Timone, Service d'Hématologie-Oncologie Pédiatrique, Marseille, France
| | - Xavier Rialland
- CHU Angers, Service d'Hémato-Oncologie Pédiatrique, Angers, France
| | - Sylvie Fasola
- Hôpital Trousseau, Service d'Hémato-Oncologie Pédiatrique, Paris, France
| | - Eve Lapouble
- Institut Curie, Unité de Génétique Somatique, Paris, France
| | - Paul Fréneaux
- Institut Curie, Laboratoire d'anatomie pathologique, Paris, France
| | - Michel Peuchmaur
- APHP, hôpital Universitaire Robert Debré, Service de Pathologie, Paris, France, et Université Diderot Paris 7, Sorbonne Paris Cité, Paris, France
| | - Jean Michon
- Institut Curie, Département de Pédiatrie, Paris, France
| | - Olivier Delattre
- INSERM U830, Laboratoire de Génétique et Biologie des Cancers, Institut Curie, Paris, France
| | - Gudrun Schleiermacher
- Institut Curie, Département de Pédiatrie, Paris, France
- INSERM U830, Laboratoire de Génétique et Biologie des Cancers, Institut Curie, Paris, France
- * E-mail:
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Schleiermacher G, Javanmardi N, Bernard V, Leroy Q, Cappo J, Rio-Frio T, Pierron G, Combaret V, Speleman F, Djos A, Ora I, Hedborg F, Holmqvist BM, Abrahamsson J, Peuchmaur M, Michon J, Janoueix-Lerosey I, Kogner P, Delattre O, Martinsson T. Emergence of new ALK mutations at relapse of neuroblastoma. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.11006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | - Frank Speleman
- Centre for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Anna Djos
- University of Gothenburg, Gothenburg, Sweden
| | | | - Fredrik Hedborg
- Uppsala University/County Council of Gavleborg, Gavle, Sweden
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Orbach D, Sarnacki S, Brisse HJ, Gauthier-Villars M, Jarreau PH, Tsatsaris V, Baruchel A, Zerah M, Seigneur E, Peuchmaur M, Doz F. Neonatal cancer. Lancet Oncol 2014; 14:e609-20. [PMID: 24275134 DOI: 10.1016/s1470-2045(13)70236-5] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Neonatal cancer is rare and comprises a heterogeneous group of neoplasms with substantial histological diversity. Almost all types of paediatric cancer can occur in fetuses and neonates; however, the presentation and behaviour of neonatal tumours often differs from that in older children, leading to differences in diagnosis and management. The causes of neonatal cancer are unclear, but genetic factors probably have a key role. Other congenital abnormalities are frequently present. Teratoma and neuroblastoma are the most common histological types of neonatal cancer, with soft-tissue sarcoma, leukaemia, renal tumours, and brain tumours also among the more frequent types. Prenatal detection, most often on routine ultrasound or in the context of a known predisposition syndrome, is becoming more common. Treatment options pose challenges because of the particular vulnerability of the population. Neonatal cancer raises diagnostic, therapeutic, and ethical issues, and management requires a multidisciplinary approach.
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Affiliation(s)
- Daniel Orbach
- Department of Paediatric Oncology, Institut Curie, Paris, France
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Bignon A, Gaudin F, Hémon P, Tharinger H, Mayol K, Walzer T, Loetscher P, Peuchmaur M, Berrebi D, Balabanian K. CCR1 inhibition ameliorates the progression of lupus nephritis in NZB/W mice. J Immunol 2013; 192:886-96. [PMID: 24367031 DOI: 10.4049/jimmunol.1300123] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Systemic lupus erythematosus is a chronic inflammatory autoimmune disease, the development of which is characterized by a progressive loss of renal function. Such dysfunction is associated with leukocyte infiltration in the glomerular and tubulointerstitial compartments in both human and experimental lupus nephritis. In this study, we investigated the role of the Ccr1 chemokine receptor in this infiltration process during the progression of nephritis in the lupus-prone New Zealand Black/New Zealand White (NZB/W) mouse model. We found that peripheral T cells, mononuclear phagocytes, and neutrophils, but not B cells, from nephritic NZB/W mice were more responsive to Ccr1 ligands than the leukocytes from younger prenephritic NZB/W mice. Short-term treatment of nephritic NZB/W mice with the orally available Ccr1 antagonist BL5923 decreased renal infiltration by T cells and macrophages. Longer Ccr1 blockade decreased kidney accumulation of effector/memory CD4(+) T cells, Ly6C(+) monocytes, and both M1 and M2 macrophages; reduced tubulointerstitial and glomerular injuries; delayed fatal proteinuria; and prolonged animal lifespan. In contrast, renal humoral immunity was unaffected in BL5923-treated mice, which reflected the unchanged numbers of infiltrated B cells in the kidneys. Altogether, these findings define a pivotal role for Ccr1 in the recruitment of T and mononuclear phagocyte cells to inflamed kidneys of NZB/W mice, which in turn contribute to the progression of renal injury.
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Affiliation(s)
- Alexandre Bignon
- Université Paris-Sud, Laboratoire "Cytokines, Chimiokines et Immunopathologie," Unité Mixte de Recherche S996, 92140 Clamart, France
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Kohler J, Rubie H, Castel V, Beiske K, Holmes K, Gambini C, Casale F, Munzer C, Erminio G, Parodi S, Navarro S, Marquez C, Peuchmaur M, Cullinane C, Brock P, Valteau-Couanet D, Garaventa A, Haupt R. Treatment of children over the age of one year with unresectable localised neuroblastoma without MYCN amplification: Results of the SIOPEN study. Eur J Cancer 2013; 49:3671-9. [DOI: 10.1016/j.ejca.2013.07.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 06/06/2013] [Accepted: 07/01/2013] [Indexed: 10/26/2022]
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Suganuma R, Wang LL, Sano H, Naranjo A, London WB, Seeger RC, Hogarty MD, Gastier-Foster JM, Look AT, Park JR, Maris JM, Cohn SL, Amann G, Beiske K, Cullinane CJ, d’Amore ESG, Gambini C, Jarzembowski JA, Joshi VV, Navarro S, Peuchmaur M, Shimada H. Peripheral neuroblastic tumors with genotype-phenotype discordance: a report from the Children's Oncology Group and the International Neuroblastoma Pathology Committee. Pediatr Blood Cancer 2013; 60:363-70. [PMID: 22744966 PMCID: PMC3397468 DOI: 10.1002/pbc.24238] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 05/29/2012] [Indexed: 12/31/2022]
Abstract
BACKGROUND Of 4,706 peripheral neuroblastic tumors (pNTs) registered on the Children's Cancer Group and Children's Oncology Group Neuroblastoma Study between 1989 and 2010, 51 cases (1.1%) had genotype-phenotype discordance characterized by MYCN amplification (indicating poor prognosis) and Favorable Histology (indicating better prognosis). PROCEDURE To distinguish prognostic subgroups in the genotype-phenotype discordant pNTs, two subgroups, "conventional" and "bull's eye," were identified based on the nuclear morphology. The "conventional" tumors (35 cases) included: Neuroblastoma, poorly differentiated subtype (NB-PD, 26 cases) with "salt-and-pepper" nuclei; neuroblastoma, differentiating subtype (4 cases); ganglioneuroblastoma, intermixed (3 cases); and ganglioneuroma, maturing subtype (2 cases). The "bull's eye" tumors included NB-PD with prominent nucleoli (16 cases). Clinicopathologic characteristics of these two subgroups were analyzed. N-myc protein expression was tested immunohistochemically on available tumors. RESULTS No significant difference was found between these two subgroups in the distribution of prognostic factors such as age at diagnosis, clinical stage, histopathology category/subtype, mitosis-karyorrhexis index, ploidy, 1p LOH, and unbalanced 11q LOH. However, prognosis of the patients with "conventional" tumors (5-year EFS 85.7 ± 12.2%; OS 89.3 ± 10.3%) was significantly better than those with "bull's eye" tumors (EFS 31.3 ± 13.0%; OS 42.9 ± 16.2%; P = 0.0010 and 0.0008, respectively). Immunohistochemically all (11/11) tested "conventional" tumors were negative, and 10/11 tested "bull's eye" tumors were positive for N-myc protein expression. CONCLUSIONS Based on the presence or absence of prominent nucleoli (the putative site of RNA synthesis/accumulation leading to N-myc protein expression), two prognostic subgroups, "conventional" with a better prognosis and "bull's eye" with a poor prognosis, were distinguished among the genotype-phenotype discordant pNTs.
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Affiliation(s)
- Rie Suganuma
- Department of Pathology and Laboratory Medicine, Children’s Hospital Los Angeles and University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Larry L. Wang
- Department of Pathology and Laboratory Medicine, Children’s Hospital Los Angeles and University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Hideki Sano
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Arlene Naranjo
- Department of Biostatistics, Colleges of Medicine and Public Health & Health Professions, University of Florida, Gainesville, Florida, USA
| | - Wendy B. London
- Children’s Hospital Boston and Dana-Farber Harvard Cancer Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Robert C. Seeger
- Division of Hematology/Oncology, Children’s Hospital Los Angeles and University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Michael D. Hogarty
- Division of Oncology, The Children’s Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Julie M. Gastier-Foster
- Department of Pathology and Laboratory Medicine, Nationwide Children’s Hospital, Ohio University College of Medicine, Columbus, Ohio, USA
| | - A. Thomas Look
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Julie R. Park
- Department of Pediatrics, Seattle Children’s Hospital and University of Washington School of Medicine, Seattle, Washington, USA
| | - John M. Maris
- Division of Oncology, The Children’s Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Susan L. Cohn
- Department of Pediatrics, Division of Hematology/Oncology, University of Chicago, Chicago, Illinois, USA
| | - Gabriele Amann
- Clinical Institute of Pathology, Medical University of Vienna, AKH, Vienna, Austria
| | - Klaus Beiske
- Department of Pathology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Catherine J. Cullinane
- Department of Histopathology, Leeds Teaching Hospitals Trust, St James’s University Hospital, Leeds, UK
| | | | - Claudio Gambini
- Department of Research and Diagnostic, IRCCS Istituto G. Gaslini, Genova, Italy
| | - Jason A. Jarzembowski
- Department of Pathology, Children’s Hospital of Wisconsin, Milwaukee, Wisconsin, USA
| | - Vijay V. Joshi
- Department of Pathology, Medical College of Virginia, Richmond, Virginia, USA
| | - Samuel Navarro
- Department of Pathology, Medical School, University of Valencia, Valencia, Spain
| | - Michel Peuchmaur
- Univ Paris Diderot, Sorbonne Paris Cité ; APHP, Hop. R. Debré, Service de Pathologie, Paris, France
| | - Hiroyuki Shimada
- Department of Pathology and Laboratory Medicine, Children’s Hospital Los Angeles and University of Southern California Keck School of Medicine, Los Angeles, California, USA
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Bielle F, Fréneaux P, Jeanne-Pasquier C, Maran-Gonzalez A, Rousseau A, Lamant L, Paris R, Pierron G, Victor Nicolas A, Sastre-Garau X, Delattre O, Bourdeaut F, Peuchmaur M. L’immunomarquage PHOX2B : un nouvel outil pour le diagnostic des neuroblastomes indiffenciés au sein des tumeurs à petites cellules rondes de l’enfant. Ann Pathol 2012. [DOI: 10.1016/j.annpat.2012.09.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Thachil E, Hugot JP, Arbeille B, Paris R, Grodet A, Peuchmaur M, Codogno P, Barreau F, Ogier-Denis E, Berrebi D, Viala J. Abnormal activation of autophagy-induced crinophagy in Paneth cells from patients with Crohn's disease. Gastroenterology 2012; 142:1097-1099.e4. [PMID: 22285936 DOI: 10.1053/j.gastro.2012.01.031] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 01/10/2012] [Accepted: 01/15/2012] [Indexed: 01/07/2023]
Abstract
Autophagy-related 16 like-1 (ATG16L-1), immunity-related GTPase-M (IRGM), and nucleotide-binding oligomerization domain-containing 2 (NOD2) regulate autophagy, and variants in these genes have been associated with predisposition to Crohn's disease (CD). However, little is known about the role of autophagy in CD. Intestinal biopsies from untreated pediatric patients with CD, celiac disease, or ulcerative colitis were analyzed by immunohistochemistry and electron microscopy. We observed that autophagy was specifically activated in Paneth cells from patients with CD, independently of mucosal inflammation or disease-associated variants of ATG16L1 or IRGM. In these cells, activation of autophagy was associated with a significant decrease in number of secretory granules and features of crinophagy. These observations might account for the disorganization of secretory granules previously reported in Paneth cells from patients with CD.
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Piard J, Verloes A, Cavé H, Peuchmaur M, Bennaceur S, Leheup B. Extensive abdominal lipomatosis in a patient with Noonan/LEOPARD syndrome (Noonan syndrome-Multiple Lentigines). Am J Med Genet A 2012; 158A:1406-10. [PMID: 22528600 DOI: 10.1002/ajmg.a.35329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Accepted: 02/13/2012] [Indexed: 12/31/2022]
Abstract
Noonan syndrome (NS) is a tumor predisposing disorder. Leukemia is observed in 1-3% of patients with NS, with rare occurrences of solid tumors. It also appears to predispose to non-malignant tumors. We report on a 26-year-old female with features of Noonan syndrome-Multiple Lentigines and a heterozygous mutation: c.1517A > C-p.Gln506Pro in the PTPN11 gene. The patient developed an unusual extensive lipomatosis and we discuss possible relationship between her lipomatosis and NS.
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Affiliation(s)
- Juliette Piard
- Centre de Référence Syndromes Malformatifs et Anomalies du Développement, Service de Médecine Infantile III et Génétique Clinique, CHU de Nancy et PRES de l'Université de Lorraine, UHP, Nancy, France.
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Zeidan S, El Ghoneimi A, Peuchmaur M, Bingen E, Bonacorsi S. Effect of partial ureteral obstruction and bacterial virulence on the occurrence of renal scarring in a mouse model. Urology 2012; 80:486.e1-7. [PMID: 22516355 DOI: 10.1016/j.urology.2012.02.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 01/13/2012] [Accepted: 02/13/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the effect of the infection and the obstruction of urinary tract on renal parenchyma, we developed a model of ascending urinary infection in mice with partial unilateral obstructive uropathy. METHODS Six week-old CBA/J mice were operated on to perform a right partial ureteral obstruction and challenged transurethrally with Escherichia coli CFT073 (high virulent strain) or E. coli Mez (low virulent strain). Level of infection of urine and kidneys, score of inflammation and fibrosis of kidneys, and kidney weight ratio (KWR) in the short and long term were studied. RESULTS At short-term (72 hours) experimentation, partial ureteral obstruction does not influence the level of kidney infection in terms of bacterial count, and the score of inflammation regardless of whether a virulent or low virulent strain was used. At long-term (42 days) experimentation, E. coli Mez was eliminated from all mice kidneys, but CFT073 persisted in almost all; obstruction did not influence the level of kidney infection with CFT073 but a significant difference of KWR and the inflammation and fibrosis score between obstructed and unobstructed kidneys was found (P = .0078; P = .036, respectively). Although the E. coli Mez strain did not persist in renal parenchyma, severe damage of the renal parenchyma was observed. CONCLUSION The proposed model is similar to the obstructive uropathy in children in which ureteral obstruction is present before the onset of infection. The association of obstruction and urinary infection impairs kidney growth and favors the occurrence of renal damage.
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Affiliation(s)
- Smart Zeidan
- Department of Pediatric Surgery and Urology, AP-HP, Robert Debré University Hospital, University of Paris Diderot, Paris, France.
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