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4 results on '"Gardin, Claude"'

1. Incidence of ATRX mutations in myelodysplastic syndromes, the value of microcytosis

Author

Herbaux, Charles, Duployez, Nicolas, Badens, Catherine, Poret, Nicolas, Gardin, Claude, Decamp, Mathieu, Eclache, Virginie, Daliphard, Sylvie, Murati, Anne, Cony-Makhoul, Pascale, Cheze, Stéphane, Beve, Blandine, Lacoste, Caroline, Prebet, Thomas, Hunault-Berger, Mathilde, Maloisel, Frédéric, Renneville, Aline, Figeac, Martin, Stamatoullas-Bastard, Aspasia, Bastard, Christian, Fenaux, Pierre, Preudhomme, Claude, Rose, Christian, Service d'Hématologie [Institut Catholique de Lille, Lille], Institut Catholique de Lille (ICL), Université catholique de Lille (UCL)-Université catholique de Lille (UCL), Service des Maladies du Sang [CHU Lille] (SMS), Hôpital Claude Huriez [Lille], CHU Lille-CHU Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire d'Hématologie [CHRU Lille] (Centre de Biologie et de Pathologie), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire de Génétique Moléculaire [Hôpital de la Timone - APHM], Département de génétique médicale [Hôpital de la Timone - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut pour la recherche sur le cancer de Lille [Lille] (IRCL), Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Génétique [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service d'hématologie biologique [Avicenne], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Service d'Hématologie Biologique [Hôpital Robert Debré, Paris], AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Service d'Hématologie [CH Annecy], CH Annecy, Laboratoire d'Hématologie Biologique [CHU Caen], Service d'hématologie clinique [Avicenne], Centre de Recherche en Cancérologie Nantes-Angers (CRCNA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Laennec-Centre National de la Recherche Scientifique (CNRS)-Faculté de Médecine d'Angers-Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'hématologie [Angers], PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Laboratoire d'Hématologie [Strasbourg], CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), GFM (Groupe Francophone des Myelodysplasies), Bernardo, Elizabeth, Service des Maladies du Sang [CHRU Lille], Institut National de la Santé et de la Recherche Médicale (INSERM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13)-Hôpital Avicenne [AP-HP]

Subjects
Aged, 80 and over, X-linked Nuclear Protein, DNA Mutational Analysis, DNA Helicases, Gene Expression, Nuclear Proteins, [SDV.CAN]Life Sciences [q-bio]/Cancer, Middle Aged, Hematopoietic Stem Cells, Survival Analysis, [SDV.CAN] Life Sciences [q-bio]/Cancer, Mutation Rate, alpha-Thalassemia, hemic and lymphatic diseases, Myelodysplastic Syndromes, Humans, Aged
Abstract

International audience; Acquired α-thalassemia myelodysplastic syndrome (MDS) (ATMDS) is an acquired syndrome characterized by a somatic point mutation or splicing defect in the ATRX gene in patients with myeloid disorders, primarily MDS. In a large MDS patient series, the incidence of ATMDS was below 0.5%. But no large series has yet assessed the incidence of ATMDS in microcytic MDS. In this study, we focused on patients with MDS and unexplained microcytosis, which was defined as absence of iron deficiency, inflammatory disease, or history of inherited hemoglobinopathy. Our data confirm the low frequency of ATRX mutations in MDS: 0% in an unselected clinical trial cohort of 80 low risk MDS, 0.2-0.8% in a multicenter registry of 2,980 MDS and 43% of MDS with unexplained microcytosis in this same registry. In addition, we reported four novel mutations of the ATRX gene in ATMDS. This study further determines the frequency of ATRX mutations and highlights the importance of microcytosis to detect ATRX mutations within MDS patients.

Published
2015

2. Risk factors and decision criteria for intensive chemotherapy in older patients with acute myeloid leukemia

Author

Malfuson, Jean-Valère, Etienne, Anne, Turlure, Pascal, De Revel, Thierry, Thomas, Xavier, Contentin, Nathalie, Terré, Christine, Rigaudeau, Sophie, Bordessoule, Dominique, Vey, Norbert, Gardin, Claude, Dombret, Hervé, Renseigné, Non, Service d'Hématologie clinique et thérapie cellulaire [CHU Limoges], CHU Limoges, Génétique, immunothérapie, chimie et cancer (GICC), UMR 6239 CNRS [2008-2011] (GICC UMR 6239 CNRS), Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier de Versailles André Mignot (CHV), Service d'Hématologie biologique [CHU Limoges], Université de Limoges (UNILIM), Physiologie Moléculaire de la Réponse Immune et des Lymphoproliférations (PMRIL), Université de Limoges (UNILIM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Centre National de la Recherche Scientifique (CNRS), Lymphocyte et cancer, IFR105-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Tours-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, MESH: Decision Making, Multivariate analysis, Leukocyte Count, 0302 clinical medicine, MESH: Aged, 80 and over, MESH: Practice Guidelines as Topic, Risk Factors, MESH: Risk Factors, Epidemiology, Aged, 80 and over, MESH: Aged, Clinical Trials as Topic, Hematology, Age Factors, Myeloid leukemia, Multiple-criteria decision analysis, 3. Good health, Leukemia, Myeloid, Acute, 030220 oncology & carcinogenesis, MESH: Survival Analysis, Cytogenetic Analysis, Practice Guidelines as Topic, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, MESH: Leukemia, Myeloid, Acute, MESH: Daunorubicin, medicine.medical_specialty, MESH: Clinical Trials as Topic, Decision Making, Antineoplastic Agents, 03 medical and health sciences, Internal medicine, medicine, Humans, MESH: Patient Selection, Risk factor, Intensive care medicine, Aged, MESH: Age Factors, MESH: Humans, business.industry, Patient Selection, MESH: Cytogenetic Analysis, Daunorubicin, MESH: Idarubicin, Cancer, medicine.disease, Survival Analysis, MESH: Male, MESH: Leukocyte Count, MESH: Antineoplastic Agents, False positive rate, business, Idarubicin, MESH: Female, 030215 immunology
Abstract

International audience; BACKGROUND: There is a need for standardization of treatment decisions in older patients with acute myeloid leukemia. The aim of the present study was to analyze the decisional value of poor risk factors in 416 elderly patients treated in the ALFA-9803 trial in order to derive a decisional index. DESIGN AND METHODS: Standard multivariate analysis was used to identify risk factors for overall survival. Risk factors were then considered as good decision tools if associated with a frequency >10% and a false positive rate or =75 years, performance status > or =2, and white cell count > or =50 x 10(9)/L. This simple two-class decisional index, which was validated in an independent patient set, enabled us to discriminate 100 patients (24%) who had an estimated overall survival of only 19% at 12 months, with a good 9% false positive rate. CONCLUSIONS: We propose waiting for cytogenetic information before making treatment decisions in elderly patients with acute myeloid leukemia. Those patients with unfavorable cytogenetics, as well as patients with at least two of the following features, age > or =75 years, performance status > or =2, and white cell count > or =50 x 10(9)/L, should not be considered for standard intensive chemotherapy (ClinicalTrials.gov identifier: NCT00363025).

Published
2008

3. Very Long Term Outcome of Acute Promyelocytic Leukemia After Treatment with All Trans Retinoic Acid and Chemotherapy: The European APL Group Experience

Author

Ades, Lionel, Guerci, Agnes, Raffoux, Emmanuel, Miguel Sanz, Chevallier, Patrice, Lapusan, Simona, Recher, Christian, Thomas, Xavier, Rayon, Chelo, Castaigne, Sylvie, Tournilhac, Olivier, Botton, Stephane, Ifrah, Norbert, Cahn, Jean-Yves, Solary, Eric, Gardin, Claude, Fegeux, Nathalie, Bordessoule, Dominique, Ferrant, Augustin, Meyer, Sandrine, Vey, Norbert, Dombret, Herve, Degos, Laurent, Chevret, Sylvie, and Fenaux, Pierre

Subjects
Immunology, Cell Biology, Hematology, Biochemistry
Abstract

Abstract 2088 Poster Board II-65 Background: APL is highly curable with the combination of ATRA and anthracycline based chemotherapy (CT), but very long term results of this treatment remain unpublished. We present here the very long term results of APL93, that included newly diagnosed patients ( pts) between 1993 and 1998, with a 10 year median follow-up, particularly focusing on late events. Methods: For induction treatment. Pts aged ≤65 years with WBC < 5,000/μL were randomized between ATRA 45 mg/m2/d followed by CT (DNR 60 mg/m2/d × 3 d + AraC 200 mg/m2/d for 7 d :ATRA→CT group) or ATRA plus CT (ATRA+CT), where the same CT was started on day 3 of ATRA treatment. After CR achievement, they received 2 consolidation courses of DNR and AraC (the first identical to the induction course, the second with DNR 45 mg/m2/d for 3 days and 1g/m2/12h AraC for 4 days). Pts with baseline WBC> 5,000/μL (irrespective of their age) and pts aged 66-75 years with WBC count ≤ 5,000/μL were not randomized but received ATRA with addition of CT on day 1 of ATRA treatment (high WBC group) and the same schedule as in the ATRA→CT group (elderly group), respectively. The elderly group received only the first consolidation course. For maintenance, pts were randomized to receive or not (2×2 analysis) intermittent ATRA (45 mg/m2 /d, 15 days every 3 months) and to receive or not continuous CT with 6MP (90 mg/m 2 /d, orally) and MTX (15 mg/m 2 /wk, orally) scheduled for 2 years. Interim results of this trial have been published (Blood 1999, vol 94, 1192-200). Results: In the 576 APL included, the CR rate was 87.3% and 90.7% in the elderly and the high WBC groups, respectively (resp), and ,in randomized pts, was 92.6% and 96.2% in the ATRA→CT and ATRA+CT groups , resp(p= 0.19). With a median follow-up of 121 months, 142 (26.6%) pts had relapsed, 59 (11%) had died in CR and 329 (61.7%) remained in first CR. 18 (12.7% of the relapses, 3.3% of the patients in CR), 9 and 3 relapses occurred after 4, 6 and 8 years, resp. Based on initial stratification, the 10-year cumulative incidence of relapse (CIR) was 16.5% in pts 5,000/μl, the 10-year CIR was 68.4%, 53.1%, 32.8% and 20.6% with no maintenance, ATRA alone, CT alone and both, resp (p < 0.0001). In pts with WBC < 5000/μL, the 10-year CIR was 29.2%, 22.9%, 21.0% and 11.5% with no maintenance, ATRA alone, CT alone and both, respectively (p =0.069). 41/322 pts received maintenance 1 yr (HR= 0.16 p< 0.0001). 59 patients (11%) died in first CR ( 10-year cum incidence (CI) of 5.7%, 15.4% and 21.7% in patients aged < 55, 55-65 , > 65 y, resp). Sepsis secondary to neutropenia (occurring during consolidation but also in 6 cases, during maintenance) and solid tumors accounted for 39% and 15% of death in CR, respectively. CI of secondary tumors and MDS was 1.4% and 0.2% at 5 years, 2.7% and 1.1% at 10 years. Conclusion: Our results with a median follow-up of 10 years, confirm that the combination of ATRA and chemotherapy can cure > 75% of APL and show the long term usefulness of sufficiently prolonged maintenance treatment, particularly in pts with initial WBC counts >5000/μl and, in pts with WBC counts Disclosures: No relevant conflicts of interest to declare.

4. Role of Allogeneic Reduced Intensity Conditioning Stem Cell Transplantation (RIC-SCT) in Older Patients with Acute Myeloid Leukemia (AML): Analysis of the ALFA-1200 Study

Author

Gardin, Claude, Pautas, Cecile, Lemasle, Emilie, Bourhis, Jean-Henri, Ades, Lionel, Marolleau, Jean-Pierre, Malfuson, Jean Valere, Gastaud, Lauris, Raffoux, Emmanuel, Cano, Isabel, Braun, Thorsten, Thomas, Xavier, Chantepie, Sylvain, Cluzeau, Thomas, Botton, Stephane, Berthon, Celine, Papoular, Benjamin, Boissel, Nicolas, Claude Preudhomme, Terre, Christine, Socie, Gerard, Michallet, Mauricette, Yakoub-Agha, Ibrahim, Celli-Lebras, Karine, and Dombret, Herve

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