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Leroy H, Gadaud N, Bérard E, Klein E, Luquet I, Vial J, Rieu J, Lechevalier N, Tavitian S, Leguay T, Largeaud L, Bidet A, Delabesse E, Sarry A, de Grande A, Récher C, Pigneux A, Bertoli S, Dumas P. Dismal outcome of refractory or relapsing patients with myelodysplasia-related acute myeloid leukemia partially alleviated by intensive chemotherapy. Cancer Med 2024; 13:e7003. [PMID: 38400682 PMCID: PMC10891460 DOI: 10.1002/cam4.7003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 01/08/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Acute myeloid leukemia (AML) with myelodysplasia-related characteristics is a heterogeneous subset of AML that has been challenged throughout the history of myeloid malignancies classifications, considered to have similar outcomes as intermediate- or adverse-risk AML depending on the subgroup. However, little is known about the fate of these patients in refractory or relapsed situation (R/R) after first line therapy. METHODS A large series of R/R AML patients, recorded in the French DATAML registry, have received either intensive chemotherapy (ICT), azacitidine (AZA) as single agent, or best supportive care (BSC). A cohort of 183 patients (median age 63-year-old) with what was called at the time AML-MRC has been explored, and data are reported here. RESULTS Patient status was refractory for 93, while 90 had relapsed. Respectively, 88, 34, and 61 were included in the three treatment arms. The median OS of the whole cohort was 4.2 months (95%CI: 3.1-5.6) with a mean 1-year overall survival of 24% ± 3.2%. There was no significant survival difference between refractory and relapsed patients. The BSC group had overall a significantly worse outcome (p = 0.0001), and this remained true in both refractory (p = 0.01) and relapsed (p = 0.002) patients. Similar survivals were observed in both groups comparing ICT and AZA. CONCLUSIONS These data, reporting about an ill-explored population, indicate the poor prognosis of this condition where both ICT and AZA can be proposed. The latter, which was demonstrated here to be a feasible option, should be added to new targeted therapies.
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Affiliation(s)
- Harmony Leroy
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie CellulaireBordeauxFrance
| | - Noémie Gadaud
- Service d'HématologieCentre Hospitalier Universitaire de ToulouseInstitut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | - Emilie Bérard
- Centre Hospitalier Universitaire de Toulouse, Service d'Epidémiologie, CERPOP, Inserm, Université Toulouse III Paul SabatierToulouseFrance
| | - Emilie Klein
- CHU Bordeaux, Laboratoire d'Hématologie BiologiqueBordeauxFrance
| | - Isabelle Luquet
- Laboratoire d'HématologieCentre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | | | - Jean‐Baptiste Rieu
- Laboratoire d'HématologieCentre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | | | - Suzanne Tavitian
- Service d'HématologieCentre Hospitalier Universitaire de ToulouseInstitut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | - Thibaut Leguay
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie CellulaireBordeauxFrance
| | - Laetitia Largeaud
- Laboratoire d'HématologieCentre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | - Audrey Bidet
- CHU Bordeaux, Laboratoire d'Hématologie BiologiqueBordeauxFrance
| | - Eric Delabesse
- Laboratoire d'HématologieCentre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | - Audrey Sarry
- Service d'HématologieCentre Hospitalier Universitaire de ToulouseInstitut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | | | - Christian Récher
- Service d'HématologieCentre Hospitalier Universitaire de ToulouseInstitut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | - Arnaud Pigneux
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie CellulaireBordeauxFrance
- Université de Bordeaux, Bordeaux, Institut National de la Santé et de la Recherche MédicaleBordeauxFrance
| | - Sarah Bertoli
- Service d'HématologieCentre Hospitalier Universitaire de ToulouseInstitut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | - Pierre‐Yves Dumas
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie CellulaireBordeauxFrance
- Université de Bordeaux, Bordeaux, Institut National de la Santé et de la Recherche MédicaleBordeauxFrance
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2
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Row C, Lechevalier N, Vial JP, Mimoun A, Bastie JN, Lafon I, Pigneux A, Leguay T, Callanan M, Maynadie M, Béné MC, Dumas PY, Guy J. Prognostic value of postinduction medullary myeloid recovery by flow cytometry in acute myeloid leukemia. EJHaem 2024; 5:84-92. [PMID: 38406512 PMCID: PMC10887270 DOI: 10.1002/jha2.822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/29/2023] [Accepted: 10/16/2023] [Indexed: 02/27/2024]
Abstract
Risk stratification and treatment response evaluation are key features in acute myeloid leukemia (AML) management. Immunophenotypic and molecular approaches all rely on the detection of persisting leukemic cells by measurable residual disease techniques. A new approach is proposed here by assessing medullary myeloid maturation by flow cytometry through a myeloid progenitor ratio (MPR). The normal MPR range was defined using reference normal bone marrows (n = 48). MPR was considered balanced if between 1 and 4 and unbalanced if < 1 or > 4. MPR was retrospectively assessed at baseline and post-induction for 206 newly diagnosed AML patients eligible for intensive treatment from two different French centers. All AML baseline MPR were unbalanced and thus significantly different from normal MPR (p < 0.0001). Patients with an unbalanced MPR after induction had worse 3-year overall survival (OS) (44.4% vs. 80.2%, HR, 2.96; 95% CI, 1.81-4.84, p < 0.0001) and 3-year relapse free survival (RFS) (38.7% vs. 64.4%, HR, 2.11; 95% CI, 1.39-3.18, p < 0.001). In multivariate analysis, postinduction unbalanced MPR was significantly associated with shorter OS and RFS regardless of the European LeukemiaNet 2010 risk stratification or NPM1/FLT3-ITD status. A balanced postinduction MPR conversely conferred favorable outcomes and reflects medullary myeloid recovery.
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Affiliation(s)
- Céline Row
- Service d'Hématologie BiologiqueCHU de DijonDijonFrance
- University of Burgundy‐ISITE‐BFC‐Institut National de la Santé et de la Recherche Médicale (Inserm) UMR1231Faculty of MedicineDijonFrance
| | | | | | - Aguirre Mimoun
- Service d'Hématologie BiologiqueCHU de BordeauxBordeauxFrance
| | - Jean Noel Bastie
- University of Burgundy‐ISITE‐BFC‐Institut National de la Santé et de la Recherche Médicale (Inserm) UMR1231Faculty of MedicineDijonFrance
- Service d'Hématologie CliniqueCHU de DijonDijonFrance
| | - Ingrid Lafon
- Service d'Hématologie BiologiqueCHU de BordeauxBordeauxFrance
| | - Arnaud Pigneux
- Service d'Hématologie Clinique et de Thérapie CellulaireCHU de BordeauxBordeauxFrance
| | - Thibaut Leguay
- Service d'Hématologie Clinique et de Thérapie CellulaireCHU de BordeauxBordeauxFrance
| | - Mary Callanan
- University of Burgundy‐ISITE‐BFC‐Institut National de la Santé et de la Recherche Médicale (Inserm) UMR1231Faculty of MedicineDijonFrance
| | - Marc Maynadie
- Service d'Hématologie BiologiqueCHU de DijonDijonFrance
- University of Burgundy‐ISITE‐BFC‐Institut National de la Santé et de la Recherche Médicale (Inserm) UMR1231Faculty of MedicineDijonFrance
| | - Marie C. Béné
- CRCI2NA INSERM UMR 1307 & CNRS UMR 6075 Université de NantesNantesFrance
| | | | - Julien Guy
- Service d'Hématologie BiologiqueCHU de DijonDijonFrance
- University of Burgundy‐ISITE‐BFC‐Institut National de la Santé et de la Recherche Médicale (Inserm) UMR1231Faculty of MedicineDijonFrance
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3
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Didi I, Alliot JM, Dumas PY, Vergez F, Tavitian S, Largeaud L, Bidet A, Rieu JB, Luquet I, Lechevalier N, Delabesse E, Sarry A, De Grande AC, Bérard E, Pigneux A, Récher C, Simoncini D, Bertoli S. Artificial intelligence-based prediction models for acute myeloid leukemia using real-life data: A DATAML registry study. Leuk Res 2024; 136:107437. [PMID: 38215555 DOI: 10.1016/j.leukres.2024.107437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/19/2023] [Accepted: 01/05/2024] [Indexed: 01/14/2024]
Abstract
We designed artificial intelligence-based prediction models (AIPM) using 52 diagnostic variables from 3687 patients included in the DATAML registry treated with intensive chemotherapy (IC, N = 3030) or azacitidine (AZA, N = 657) for an acute myeloid leukemia (AML). A neural network called multilayer perceptron (MLP) achieved a prediction accuracy for overall survival (OS) of 68.5% and 62.1% in the IC and AZA cohorts, respectively. The Boruta algorithm could select the most important variables for prediction without decreasing accuracy. Thirteen features were retained with this algorithm in the IC cohort: age, cytogenetic risk, white blood cells count, LDH, platelet count, albumin, MPO expression, mean corpuscular volume, CD117 expression, NPM1 mutation, AML status (de novo or secondary), multilineage dysplasia and ASXL1 mutation; and 7 variables in the AZA cohort: blood blasts, serum ferritin, CD56, LDH, hemoglobin, CD13 and disseminated intravascular coagulation (DIC). We believe that AIPM could help hematologists to deal with the huge amount of data available at diagnosis, enabling them to have an OS estimation and guide their treatment choice. Our registry-based AIPM could offer a large real-life dataset with original and exhaustive features and select a low number of diagnostic features with an equivalent accuracy of prediction, more appropriate to routine practice.
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Affiliation(s)
| | | | - Pierre-Yves Dumas
- Centre Hospitalier Universitaire de Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France; Université de Bordeaux, Bordeaux, France; Institut National de la Santé et de la Recherche Médicale, U1035 Bordeaux, France
| | - François Vergez
- Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer Toulouse-Oncopole, Laboratoire d'hématologie, Toulouse, France; Centre de Recherches en Cancérologie de Toulouse, Université Toulouse 3 Paul Sabatier, Toulouse, France
| | - Suzanne Tavitian
- Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Service d'hématologie, Toulouse, France
| | - Laëtitia Largeaud
- Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer Toulouse-Oncopole, Laboratoire d'hématologie, Toulouse, France; Centre de Recherches en Cancérologie de Toulouse, Université Toulouse 3 Paul Sabatier, Toulouse, France
| | - Audrey Bidet
- CHU Bordeaux, Laboratoire d'Hématologie Biologique, F-33000 Bordeaux, France
| | - Jean-Baptiste Rieu
- Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer Toulouse-Oncopole, Laboratoire d'hématologie, Toulouse, France
| | - Isabelle Luquet
- Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer Toulouse-Oncopole, Laboratoire d'hématologie, Toulouse, France
| | - Nicolas Lechevalier
- CHU Bordeaux, Laboratoire d'Hématologie Biologique, F-33000 Bordeaux, France
| | - Eric Delabesse
- Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer Toulouse-Oncopole, Laboratoire d'hématologie, Toulouse, France; Centre de Recherches en Cancérologie de Toulouse, Université Toulouse 3 Paul Sabatier, Toulouse, France
| | - Audrey Sarry
- Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Service d'hématologie, Toulouse, France
| | - Anne-Charlotte De Grande
- Centre Hospitalier Universitaire de Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Emilie Bérard
- Department of Epidemiology, Health Economics and Public Health, UMR 1295 CERPOP, University of Toulouse, INSERM, UPS, Toulouse University Hospital (CHU), Toulouse, France
| | - Arnaud Pigneux
- Centre Hospitalier Universitaire de Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France; Université de Bordeaux, Bordeaux, France
| | - Christian Récher
- Centre de Recherches en Cancérologie de Toulouse, Université Toulouse 3 Paul Sabatier, Toulouse, France; Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Service d'hématologie, Toulouse, France
| | - David Simoncini
- IRIT UMR 5505-CNRS, Université Toulouse I Capitole, Toulouse, France
| | - Sarah Bertoli
- Centre de Recherches en Cancérologie de Toulouse, Université Toulouse 3 Paul Sabatier, Toulouse, France; Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Service d'hématologie, Toulouse, France.
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4
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Brett VE, Dilhuydy MS, Lechevalier N, Adjibabi AN, Gros FX, Forcade É, Letestu R, Vial JP. Principal component analysis yields results comparable to those of an elaborate Boolean strategy: simplifying the assessment of measurable residual disease in chronic lymphocytic leukemia patients. Ann Biol Clin (Paris) 2023; 81:379-387. [PMID: 37864443 DOI: 10.1684/abc.2023.1826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
INTRODUCTION Measurable residual disease (MRD) is becoming increasingly important in the chronic lymphocytic leukemia (CLL) context. It is of independent prognostic significance in terms of favorable progression-free and overall survival. The standardized methods used to assess CLL MRD are based on flow cytometry and real-time quantitative PCR. We here present a nine-color assay for CLL MRD with the ROR-1 marker antigen as recommended by the European Research Initiative (ERIC) on CLL; the sensitivity is at least 10-5. MATERIALS AND METHODS We used 54 samples to develop a new principal component analysis (PCA) method based on the Kaluza© "radar" presentation mode. We used a Navios flow cytometer (Beckman Coulter©). RESULTS We confirmed the linearity of our method over more than five dilutions. The specificity limit was 1.3×10-6 and the lower limit of detection was 3.6×10-6. Compared to the Boolean method, the sensitivity, specificity, and positive and negative predictive values of our PCA method were 100%. When MRD was detectable, PCA and Boolean assays were in agreement (linear regression, R2 = 0.99). CONCLUSION We developed a new PCA-based method for detection of CLL MRD. Our method is comparable to that of the consensus method in terms of sensitivity, and it is also much easier and faster.
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Affiliation(s)
- Victor-Emmanuel Brett
- Hematology Laboratory, CHU Bordeaux, Laboratory CHU Bordeaux, 1 avenue de Magellan, 33600 Pessac France
| | | | - Nicolas Lechevalier
- Hematology Laboratory, Vannes Hospital Center, 20 boulevard Général Maurice Guillaudot, 56000 Vannes
| | - And-Nan Adjibabi
- Hematology Laboratory, Périgueux Hospital Center, 80 avenue Georges Pompidou, 24000 Périgueux
| | | | - Édouard Forcade
- Clinical Hematology, CHU Bordeaux, 1 avenue de Magellan, 33600 Pessac France
| | - Rémi Letestu
- Hematology Laboratory, Avicenne Paris University Hospital, 125 rue de Stalingrad, 93000 Bobigny
| | - Jean-Philippe Vial
- Hematology Laboratory, CHU Bordeaux, Laboratory CHU Bordeaux, 1 avenue de Magellan, 33600 Pessac France
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5
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Brett VE, Lechevalier N, Trimoreau F, Dussiau C, Dimicoli-Salazar S, Coster L, Luquet I, Nadal N, Ribourtout B, Chapiro E, Lefebvre C, Tondeur S, Balducci E, Nguyen-Khac F, Borie C, Radford-Weiss I, Barin C, Eclache V, Mansier O, Bidet A. The presence of a chromosomal abnormality in cytopenia without dysplasia identifies a category of high-risk clonal cytopenia of unknown significance. Genes Chromosomes Cancer 2023; 62:139-151. [PMID: 36412977 DOI: 10.1002/gcc.23107] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 11/23/2022] Open
Abstract
Myelodysplastic syndromes (MDS) are hematological malignancies classically defined by the presence of cytopenia(s) and dysmorphic myeloid cells. It is now known that MDS can be preceded by a pre-malignant condition called clonal cytopenia of unknown significance (CCUS), which associates a clonality marker with cytopenia in the absence of criteria of dysplasia. However, to date, it is not clear whether chromosomal abnormalities should be considered in the definition of CCUS or if they carry a prognostic impact in CCUS patients. In this study, we analyzed the clinico-biological features and outcomes of 34 patients who presented with one or more cytopenias, an absence of significant dysplasia, and a presence of a chromosomal abnormality (CA). We named this entity chromosomal abnormality with cytopenia of undetermined significance (CACtUS). We show that these patients are slightly older than MDS patients and that they more frequently presented with normocytic anemia. Most CACtUS patients exhibited only one unbalanced CA. The number and type of mutations were comparable between CACtUS patients and MDS patients. Regardless of the cytogenetic abnormality, the clinicobiological characteristics, overall survival, and risk of progression to high-risk (HR) MDS were similar between CACtUS patients and low-risk MDS patients. Thus, we suggest that CACtUS patients can be considered as HR-CCUS and should receive the follow-up regimen recommended for MDS patients.
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Affiliation(s)
| | | | - Franck Trimoreau
- Laboratoire d'Hématologie Biologique, CHU Limoges, Limoges, France
| | - Charles Dussiau
- Laboratoire d'Hématologie Biologique, CHU Bordeaux, Bordeaux, France.,INSERM U1034, Biology of cardiovascular disease, Pessac, France
| | | | - Lucie Coster
- Laboratoire d'Hématologie, CHU Toulouse, site IUCT-O, Toulouse, France.,Groupe Francophone de Cytogénétique Hématologique (GFCH)
| | - Isabelle Luquet
- Laboratoire d'Hématologie, CHU Toulouse, site IUCT-O, Toulouse, France.,Groupe Francophone de Cytogénétique Hématologique (GFCH)
| | - Nathalie Nadal
- Groupe Francophone de Cytogénétique Hématologique (GFCH).,Service de génétique chromosomique et moléculaire, CHU Dijon, Dijon, France
| | - Bénédicte Ribourtout
- Groupe Francophone de Cytogénétique Hématologique (GFCH).,Laboratoire d'Hématologie, CHU Angers, Angers, France
| | - Elise Chapiro
- Groupe Francophone de Cytogénétique Hématologique (GFCH).,Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France.,Cell Death and Drug Resistance in Lymphoproliferative Disorders Team, Centre de Recherche des Cordeliers, INSERM UMRS 1138; Sorbonne Université, Paris, France
| | - Christine Lefebvre
- Groupe Francophone de Cytogénétique Hématologique (GFCH).,Laboratoire de Cytogénétique des Hémopathies, CHU Grenoble Alpes, Grenoble, France
| | - Sylvie Tondeur
- Groupe Francophone de Cytogénétique Hématologique (GFCH).,Laboratoire d'Hématologie, CHU St-Etienne, St Etienne, France
| | - Estelle Balducci
- Groupe Francophone de Cytogénétique Hématologique (GFCH).,Laboratoire d'Hématologie, Hôpital Paul Brousse, APHP, Paris, France
| | - Florence Nguyen-Khac
- Groupe Francophone de Cytogénétique Hématologique (GFCH).,Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France.,Cell Death and Drug Resistance in Lymphoproliferative Disorders Team, Centre de Recherche des Cordeliers, INSERM UMRS 1138; Sorbonne Université, Paris, France
| | - Claire Borie
- Groupe Francophone de Cytogénétique Hématologique (GFCH).,Laboratoire d'Hématologie, Hôpital Paul Brousse, APHP, Paris, France
| | - Isabelle Radford-Weiss
- Groupe Francophone de Cytogénétique Hématologique (GFCH).,Laboratoire de Cytogénétique, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Carole Barin
- Groupe Francophone de Cytogénétique Hématologique (GFCH).,Laboratoire de cytogénétique hématologique, Service de génétique, CHU Bretonneau, Tours, France
| | - Virginie Eclache
- Groupe Francophone de Cytogénétique Hématologique (GFCH).,Hopital Pitié-Salpétrière, AP-HP, France
| | - Olivier Mansier
- Laboratoire d'Hématologie Biologique, CHU Bordeaux, Bordeaux, France.,INSERM U1034, Biology of cardiovascular disease, Pessac, France
| | - Audrey Bidet
- Laboratoire d'Hématologie Biologique, CHU Bordeaux, Bordeaux, France.,Groupe Francophone de Cytogénétique Hématologique (GFCH)
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6
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Canali A, Vergnolle I, Bertoli S, Largeaud L, Nicolau ML, Rieu JB, Tavitian S, Huguet F, Picard M, Bories P, Vial JP, Lechevalier N, Béné MC, Luquet I, Mansat-De Mas V, Delabesse E, Récher C, Vergez F. Prognostic Impact of Unsupervised Early Assessment of Bulk and Leukemic Stem Cell Measurable Residual Disease in Acute Myeloid Leukemia. Clin Cancer Res 2023; 29:134-142. [PMID: 36318706 DOI: 10.1158/1078-0432.ccr-22-2237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/24/2022] [Accepted: 10/28/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE Acute myeloid leukemias (AML) are clonal diseases that develop from leukemic stem cells (LSC) that carry an independent prognostic impact on the initial response to induction chemotherapy, demonstrating the clinical relevance of LSC abundance in AML. In 2018, the European LeukemiaNet published recommendations for the detection of measurable residual disease (Bulk MRD) and suggested the exploration of LSC MRD and the use of multiparametric displays. EXPERIMENTAL DESIGN We evaluated the performance of unsupervised clustering for the post-induction assessment of bulk and LSC MRD in 155 patients with AML who received intensive conventional chemotherapy treatment. RESULTS The median overall survival (OS) for Bulk+ MRD patients was 16.7 months and was not reached for negative patients (HR, 3.82; P < 0.0001). The median OS of LSC+ MRD patients was 25.0 months and not reached for negative patients (HR, 2.84; P = 0.001). Interestingly, 1-year (y) and 3-y OS were 60% and 39% in Bulk+, 91% and 52% in Bulk-LSC+ and 92% and 88% in Bulk-LSC-. CONCLUSIONS In this study, we confirm the prognostic impact of post-induction multiparametric flow cytometry Bulk MRD in patients with AML. Focusing on LSCs, we identified a group of patients with negative Bulk MRD but positive LSC MRD (25.8% of our cohort) with an intermediate prognosis, demonstrating the interest of MRD analysis focusing on leukemic chemoresistant subpopulations.
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Affiliation(s)
- Alban Canali
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Inès Vergnolle
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Sarah Bertoli
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - Laetitia Largeaud
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - Marie-Laure Nicolau
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Jean-Baptiste Rieu
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Suzanne Tavitian
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Françoise Huguet
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Muriel Picard
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Pierre Bories
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Jean Philippe Vial
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Nicolas Lechevalier
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Marie Christine Béné
- Laboratoire d'Hématologie, CHU de Nantes, Nantes, CRCI²NA INSERM UMR1307, CNRS UMR 6075, France
| | - Isabelle Luquet
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Véronique Mansat-De Mas
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - Eric Delabesse
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - Christian Récher
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - François Vergez
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
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7
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Vergez F, Largeaud L, Bertoli S, Nicolau ML, Rieu JB, Vergnolle I, Saland E, Sarry A, Tavitian S, Huguet F, Picard M, Vial JP, Lechevalier N, Bidet A, Dumas PY, Pigneux A, Luquet I, Mansat-De Mas V, Delabesse E, Carroll M, Danet-Desnoyers G, Sarry JE, Récher C. Phenotypically-defined stages of leukemia arrest predict main driver mutations subgroups, and outcome in acute myeloid leukemia. Blood Cancer J 2022; 12:117. [PMID: 35973983 PMCID: PMC9381519 DOI: 10.1038/s41408-022-00712-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 11/09/2022] Open
Abstract
Classifications of acute myeloid leukemia (AML) patients rely on morphologic, cytogenetic, and molecular features. Here we have established a novel flow cytometry-based immunophenotypic stratification showing that AML blasts are blocked at specific stages of differentiation where features of normal myelopoiesis are preserved. Six stages of leukemia differentiation-arrest categories based on CD34, CD117, CD13, CD33, MPO, and HLA-DR expression were identified in two independent cohorts of 2087 and 1209 AML patients. Hematopoietic stem cell/multipotent progenitor-like AMLs display low proliferation rate, inv(3) or RUNX1 mutations, and high leukemic stem cell frequency as well as poor outcome, whereas granulocyte-monocyte progenitor-like AMLs have CEBPA mutations, RUNX1-RUNX1T1 or CBFB-MYH11 translocations, lower leukemic stem cell frequency, higher chemosensitivity, and better outcome. NPM1 mutations correlate with most mature stages of leukemia arrest together with TET2 or IDH mutations in granulocyte progenitors-like AML or with DNMT3A mutations in monocyte progenitors-like AML. Overall, we demonstrate that AML is arrested at specific stages of myeloid differentiation (SLA classification) that significantly correlate with AML genetic lesions, clinical presentation, stem cell properties, chemosensitivity, response to therapy, and outcome.
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Affiliation(s)
- François Vergez
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France. .,Université Toulouse III Paul Sabatier, Toulouse, France. .,Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France. .,Stem Cell and Xenograft Core, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
| | - Laetitia Largeaud
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France.,Université Toulouse III Paul Sabatier, Toulouse, France.,Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - Sarah Bertoli
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France.,Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Marie-Laure Nicolau
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Jean-Baptiste Rieu
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Inès Vergnolle
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Estelle Saland
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - Audrey Sarry
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Suzanne Tavitian
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Françoise Huguet
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Muriel Picard
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Jean-Philippe Vial
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Nicolas Lechevalier
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Audrey Bidet
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Pierre-Yves Dumas
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Arnaud Pigneux
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Isabelle Luquet
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Véronique Mansat-De Mas
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Eric Delabesse
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Martin Carroll
- Stem Cell and Xenograft Core, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Gwenn Danet-Desnoyers
- Stem Cell and Xenograft Core, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Jean-Emmanuel Sarry
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France.,Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Christian Récher
- Université Toulouse III Paul Sabatier, Toulouse, France. .,Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France. .,Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France.
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8
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Brett VE, Menguy S, Arcourt A, Bidet A, Lechevalier N, Leguay T, Klein E, Garnache-Ottou F, Vial JP. An unusual case of cytoplasmic CD3 expressing BPDCN supporting the T-lineage origin of plasmacytoid dendritic cells. Cytometry B Clin Cytom 2021; 102:175-177. [PMID: 34787365 DOI: 10.1002/cyto.b.22039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 10/26/2021] [Accepted: 11/03/2021] [Indexed: 11/08/2022]
Affiliation(s)
| | - Sarah Menguy
- Laboratoire d'Anathomo-pathologie, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Agathe Arcourt
- Service des maladies du sang et de thérapie cellulaire, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Audrey Bidet
- Laboratoire d'Hématologie, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Nicolas Lechevalier
- Laboratoire d'Hématologie, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Thibaut Leguay
- Service des maladies du sang et de thérapie cellulaire, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Emilie Klein
- Laboratoire d'Hématologie, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Francine Garnache-Ottou
- INSERM UMR 1098, RIGHT (Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique), Établissement Français du Sang et Université de Bourgogne Franche-Comté, Besançon, France
| | - Jean-Philippe Vial
- Laboratoire d'Hématologie, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
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9
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Vial JP, Lechevalier N, Lacombe F, Dumas PY, Bidet A, Leguay T, Vergez F, Pigneux A, Béné MC. Unsupervised Flow Cytometry Analysis Allows for an Accurate Identification of Minimal Residual Disease Assessment in Acute Myeloid Leukemia. Cancers (Basel) 2021; 13:cancers13040629. [PMID: 33562525 PMCID: PMC7914957 DOI: 10.3390/cancers13040629] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 01/12/2021] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 11/16/2022] Open
Abstract
The assessment of minimal residual disease (MRD) is increasingly considered to monitor response to therapy in hematological malignancies. In acute myeloblastic leukemia (AML), molecular MRD (mMRD) is possible for about half the patients while multiparameter flow cytometry (MFC) is more broadly available. However, MFC analysis strategies are highly operator-dependent. Recently, new tools have been designed for unsupervised MFC analysis, segregating cell-clusters with the same immunophenotypic characteristics. Here, the Flow-Self-Organizing-Maps (FlowSOM) tool was applied to assess MFC-MRD in 96 bone marrow (BM) follow-up (FU) time-points from 40 AML patients with available mMRD. A reference FlowSOM display was built from 19 healthy/normal BM samples (NBM), then simultaneously compared to the patient's diagnosis and FU samples at each time-point. MRD clusters were characterized individually in terms of cell numbers and immunophenotype. This strategy disclosed subclones with varying immunophenotype within single diagnosis and FU samples including populations absent from NBM. Detectable MRD was as low as 0.09% in MFC and 0.051% for mMRD. The concordance between mMRD and MFC-MRD was 80.2%. MFC yielded 85% specificity and 69% sensitivity compared to mMRD. Unsupervised MFC is shown here to allow for an easy and robust assessment of MRD, applicable also to AML patients without molecular markers.
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Affiliation(s)
- Jean Philippe Vial
- Hematology Biology, Flow Cytometry, Bordeaux University Hospital, 33600 Pessac, France; (J.P.V.); (N.L.); (F.L.)
| | - Nicolas Lechevalier
- Hematology Biology, Flow Cytometry, Bordeaux University Hospital, 33600 Pessac, France; (J.P.V.); (N.L.); (F.L.)
| | - Francis Lacombe
- Hematology Biology, Flow Cytometry, Bordeaux University Hospital, 33600 Pessac, France; (J.P.V.); (N.L.); (F.L.)
| | - Pierre-Yves Dumas
- Service d’Hématologie Clinique et de Thérapie Cellulaire, Bordeaux University Hospital, 33600 Pessac, France; (P.-Y.D.); (T.L.); (A.P.)
| | - Audrey Bidet
- Hematology Biology, Molecular Hematology, Bordeaux University Hospital, 33600 Pessac, France;
| | - Thibaut Leguay
- Service d’Hématologie Clinique et de Thérapie Cellulaire, Bordeaux University Hospital, 33600 Pessac, France; (P.-Y.D.); (T.L.); (A.P.)
| | - François Vergez
- Hematology Biology, IUCT Oncopôle, Toulouse University Hospital, 31000 Toulouse, France;
| | - Arnaud Pigneux
- Service d’Hématologie Clinique et de Thérapie Cellulaire, Bordeaux University Hospital, 33600 Pessac, France; (P.-Y.D.); (T.L.); (A.P.)
| | - Marie C. Béné
- Hematology Biology, Nantes University Hospital, 44000 Nantes, France
- Correspondence:
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10
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Dumas PY, Bertoli S, Bérard E, Largeaud L, Bidet A, Delabesse E, Leguay T, Leroy H, Gadaud N, Rieu JB, Vial JP, Vergez F, Lechevalier N, Luquet I, Klein E, Sarry A, de Grande AC, Pigneux A, Récher C. Real-World Outcomes of Patients with Refractory or Relapsed FLT3-ITD Acute Myeloid Leukemia: A Toulouse-Bordeaux DATAML Registry Study. Cancers (Basel) 2020; 12:cancers12082044. [PMID: 32722211 PMCID: PMC7465142 DOI: 10.3390/cancers12082044] [Citation(s) in RCA: 8] [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: 06/08/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 12/15/2022] Open
Abstract
Two recent phase 3 trials showed that outcomes for relapsed/refractory (R/R) FLT3-mutated acute myeloid leukemia (AML) patients may be improved by a single-agent tyrosine kinase inhibitor (TKI) (i.e., quizartinib or gilteritinib). In the current study, we retrospectively investigated the characteristics and real-world outcomes of R/R FLT3-internal tandem duplication (ITD) acute myeloid leukemia (AML) patients in the Toulouse-Bordeaux DATAML registry. In the study, we included 316 patients with FLT3-ITD AML that received intensive chemotherapy as a first-line treatment. The rate of complete remission (CR) or CR without hematological recovery (CRi) was 75.2%, and 160 patients were R/R after a first-line TKI-free treatment (n = 294). Within the subgroup of R/R patients that fulfilled the main criteria of the QUANTUM-R study, 48.9% received an intensive salvage regimen; none received hypomethylating agents or low-dose cytarabine. Among the R/R FLT3-ITD AML patients with CR1 durations < 6 months who received intensive TKI-free treatment, the rate of CR or CRi after salvage chemotherapy was 52.8%, and these results allowed a bridge to be transplanted in 39.6% of cases. Finally, in this QUANTUM-R standard arm-matched cohort, the median overall survival (OS) was 7.0 months and 1-, 3- and 5-year OS were 30.2%, 23.7% and 21.4%, respectively. To conclude, these real-world data show that the intensity of the second-line treatment likely affects response and transplantation rates. Furthermore, the results indicate that including patients with low-intensity regimens, such as low-dose cytarabine or hypomethylating agents, in the control arm of a phase 3 trial may be counterproductive and could compromise the results of the study.
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Affiliation(s)
- Pierre-Yves Dumas
- Service d’Hématologie Clinique et de Thérapie Cellulaire, CHU Bordeaux, F-33000 Bordeaux, France; (T.L.); (H.L.); (A.-C.d.G.); (A.P.)
- Université de Bordeaux, 33076 Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale, U1035, 33000 Bordeaux, France
- Correspondence: ; Tel.: +33-557-656-511; Fax: +33-557-656-514
| | - Sarah Bertoli
- Service d’Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (S.B.); (L.L.); (N.G.); (A.S.); (C.R.)
- Université Toulouse III Paul Sabatier, 31000 Toulouse, France; (E.D.); (F.V.)
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, 31000 Toulouse, France
| | - Emilie Bérard
- Service d’Epidémiologie, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France;
- INSERM-Université de Toulouse III, UMR 1027, 31000 Toulouse, France
| | - Laetitia Largeaud
- Service d’Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (S.B.); (L.L.); (N.G.); (A.S.); (C.R.)
- Université Toulouse III Paul Sabatier, 31000 Toulouse, France; (E.D.); (F.V.)
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, 31000 Toulouse, France
- Laboratoire d’Hématologie Biologique, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (J.B.R.); (I.L.)
| | - Audrey Bidet
- Laboratoire d’Hématologie Biologique, CHU Bordeaux, F-33000 Bordeaux, France; (A.B.); (J.-P.V.); (N.L.); (E.K.)
| | - Eric Delabesse
- Université Toulouse III Paul Sabatier, 31000 Toulouse, France; (E.D.); (F.V.)
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, 31000 Toulouse, France
- Laboratoire d’Hématologie Biologique, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (J.B.R.); (I.L.)
| | - Thibaut Leguay
- Service d’Hématologie Clinique et de Thérapie Cellulaire, CHU Bordeaux, F-33000 Bordeaux, France; (T.L.); (H.L.); (A.-C.d.G.); (A.P.)
| | - Harmony Leroy
- Service d’Hématologie Clinique et de Thérapie Cellulaire, CHU Bordeaux, F-33000 Bordeaux, France; (T.L.); (H.L.); (A.-C.d.G.); (A.P.)
| | - Noémie Gadaud
- Service d’Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (S.B.); (L.L.); (N.G.); (A.S.); (C.R.)
| | - Jean Baptiste Rieu
- Laboratoire d’Hématologie Biologique, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (J.B.R.); (I.L.)
| | - Jean-Philippe Vial
- Laboratoire d’Hématologie Biologique, CHU Bordeaux, F-33000 Bordeaux, France; (A.B.); (J.-P.V.); (N.L.); (E.K.)
| | - François Vergez
- Université Toulouse III Paul Sabatier, 31000 Toulouse, France; (E.D.); (F.V.)
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, 31000 Toulouse, France
- Laboratoire d’Hématologie Biologique, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (J.B.R.); (I.L.)
| | - Nicolas Lechevalier
- Laboratoire d’Hématologie Biologique, CHU Bordeaux, F-33000 Bordeaux, France; (A.B.); (J.-P.V.); (N.L.); (E.K.)
| | - Isabelle Luquet
- Laboratoire d’Hématologie Biologique, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (J.B.R.); (I.L.)
| | - Emilie Klein
- Laboratoire d’Hématologie Biologique, CHU Bordeaux, F-33000 Bordeaux, France; (A.B.); (J.-P.V.); (N.L.); (E.K.)
| | - Audrey Sarry
- Service d’Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (S.B.); (L.L.); (N.G.); (A.S.); (C.R.)
| | - Anne-Charlotte de Grande
- Service d’Hématologie Clinique et de Thérapie Cellulaire, CHU Bordeaux, F-33000 Bordeaux, France; (T.L.); (H.L.); (A.-C.d.G.); (A.P.)
| | - Arnaud Pigneux
- Service d’Hématologie Clinique et de Thérapie Cellulaire, CHU Bordeaux, F-33000 Bordeaux, France; (T.L.); (H.L.); (A.-C.d.G.); (A.P.)
- Université de Bordeaux, 33076 Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale, U1035, 33000 Bordeaux, France
| | - Christian Récher
- Service d’Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (S.B.); (L.L.); (N.G.); (A.S.); (C.R.)
- Université Toulouse III Paul Sabatier, 31000 Toulouse, France; (E.D.); (F.V.)
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, 31000 Toulouse, France
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11
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Lacombe F, Lechevalier N, Vial JP, Béné MC. An R-Derived FlowSOM Process to Analyze Unsupervised Clustering of Normal and Malignant Human Bone Marrow Classical Flow Cytometry Data. Cytometry A 2019; 95:1191-1197. [PMID: 31577391 DOI: 10.1002/cyto.a.23897] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 01/14/2023]
Abstract
Multiparameter flow cytometry (MFC) is a powerful and versatile tool to accurately analyze cell subsets, notably to explore normal and pathological hematopoiesis. Yet, mostly supervised subjective strategies are used to identify cell subsets in this complex tissue. In the past few years, the implementation of mass cytometry and the big data generated have led to a blossoming of new software solutions. Their application to classical MFC in hematology is however still seldom reported. Here, we show how one of these new tools, the FlowSOM R solution, can be applied, together with the Kaluza® software, to a new delineation of hematopoietic subsets in normal human bone marrow (BM). We thus combined the unsupervised discrimination of cell subsets provided by FlowSOM and their expert-driven node-by-node assignment to known or new hematopoietic subsets. We also show how this new tool could modify the MFC exploration of hematological malignancies both at diagnosis (Dg) and follow-up (FU). This can be achieved by direct comparison of merged listmodes of reference normal BM, Dg, and FU samples of a representative acute myeloblastic case tested with the same immunophenotyping panel. This provides an immediate unsupervised evaluation of minimal residual disease. © 2019 International Society for Advancement of Cytometry.
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Affiliation(s)
- Francis Lacombe
- Flow cytometry department, Hematology Laboratory, Bordeaux University Hospital, Pessac, France
| | - Nicolas Lechevalier
- Flow cytometry department, Hematology Laboratory, Bordeaux University Hospital, Pessac, France
| | - Jean Philippe Vial
- Flow cytometry department, Hematology Laboratory, Bordeaux University Hospital, Pessac, France
| | - Marie C Béné
- Hematology Biology, Nantes University Hospital, CRCINA, Nantes, France
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12
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Durand P, Lechevalier N, Duffau P, Baulier G. IgM avec M comme Myélome ? Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.211] [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: 11/28/2022]
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13
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Lebecque B, Vial J, Pigneux A, Lechevalier N. Chronic myelomonocytic leukaemia followed by blastic plasmacytoid dendritic cell neoplasm. Br J Haematol 2019; 185:398. [DOI: 10.1111/bjh.15794] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Arnaud Pigneux
- Service d'Hématologie et de thérapie cellulaire Hôpital Haut‐Lévêque Centre Hospitalier Universitaire de Bordeaux Pessac France
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14
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Magierowicz M, Lechevalier N, Freynet N, Pastoret C, Badaoui B, Ly-Sunnaram B, Fest T, Lacombe F, Wagner-Ballon O, Roussel M. Reference Values for WBC Differential by Hematoflow Analysis. Am J Clin Pathol 2019; 151:324-327. [PMID: 30383211 DOI: 10.1093/ajcp/aqy147] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objectives WBC differentials performed using flow cytometry with monoclonal antibodies have been developed in the last decade and are nowadays integrated into the routine workflow of some laboratories. Definition of reference values for each population is required in order to achieve an automatic validation of the results by laboratory software. Methods We analyzed 584 samples from three hospitals using the Hematoflow solution to define the reference values. Results Reference values are presented for five groups according to age (0-5, 6-11, 12-19, 20-69, and >69 years). Conclusions These normal values will be helpful in the definition of relevant threshold for the automatic validation of samples analyzed by flow cytometry and the flagging of pathologic samples.
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Affiliation(s)
- Marion Magierowicz
- Laboratoire Hématologie, Centre Hospitalier Universitaire Rennes, Rennes, France
| | - Nicolas Lechevalier
- Laboratoire d’Hématologie, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France
| | - Nicolas Freynet
- Département d’Hématologie et Immunologie Biologiques, Assistance Publique Hôpitaux de Paris, Hôpitaux Universitaires Henri-Mondor, Créteil, France
| | - Cedric Pastoret
- Laboratoire Hématologie, Centre Hospitalier Universitaire Rennes, Rennes, France
| | - Bouchra Badaoui
- Département d’Hématologie et Immunologie Biologiques, Assistance Publique Hôpitaux de Paris, Hôpitaux Universitaires Henri-Mondor, Créteil, France
| | - Beatrice Ly-Sunnaram
- Laboratoire Hématologie, Centre Hospitalier Universitaire Rennes, Rennes, France
| | - Thierry Fest
- Laboratoire Hématologie, Centre Hospitalier Universitaire Rennes, Rennes, France
- Inserm U1236, Microenvironment, Cell Differentiation, Immunology and Cancer, Université Rennes, Inserm, Établissement Français du Sang Bretagne, Rennes, France
| | - Francis Lacombe
- Laboratoire d’Hématologie, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France
| | - Orianne Wagner-Ballon
- Département d’Hématologie et Immunologie Biologiques, Assistance Publique Hôpitaux de Paris, Hôpitaux Universitaires Henri-Mondor, Créteil, France
- Inserm U955, Université Paris-Est, Créteil, France
| | - Mikael Roussel
- Laboratoire Hématologie, Centre Hospitalier Universitaire Rennes, Rennes, France
- Inserm U1236, Microenvironment, Cell Differentiation, Immunology and Cancer, Université Rennes, Inserm, Établissement Français du Sang Bretagne, Rennes, France
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15
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Gros FX, Cazaubiel T, Forcade E, Lechevalier N, Leguay T, Servant V, Tabrizi R, Clement L, Dumas PY, Bidet A, Pigneux A, Vigouroux S, Milpied N. Severe acute GvHD following administration of ipilimumab for early relapse of AML after haploidentical stem cell transplantation. Bone Marrow Transplant 2017; 52:1047-1048. [DOI: 10.1038/bmt.2017.78] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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16
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Lechevalier N, Dulucq S, Bidet A. A case of acute promyelocytic leukaemia with unusual cytological features and a ZBTB16-RARA fusion gene. Br J Haematol 2016; 174:502. [PMID: 27302179 DOI: 10.1111/bjh.14198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Nicolas Lechevalier
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
| | - Stéphanie Dulucq
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Audrey Bidet
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
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