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18 results on '"MESH: Transplantation Conditioning"'

1. Total body irradiation + fludarabine compared to busulfan + fludarabine as 'reduced-toxicity conditioning' for patients with acute myeloid leukemia treated with allogeneic hematopoietic cell transplantation in first complete remission: a study by the Acute Leukemia Working Party of the EBMT

Author

Giebel, Sebastian, Labopin, Myriam, Sobczyk-Kruszelnicka, Malgorzata, Stelljes, Matthias, Byrne, Jenny, Fegueux, Nathalie, Beelen, Dietrich, Rovira, Montserrat, Spyridonidis, Alexandros, Blaise, Didier, Bornhäuser, Martin, Karadogan, Ihsan, Savani, Bipin, Nagler, Arnon, Mohty, Mohamad, Martin, Sonja, Chevallier, Patrice, Neubauer, Andreas, Damaj, Gandhi, Koc, Yener, Ganser, Arnold, Collin, Matthew, Yakoub-Agha, Ibrahim, Ozdogu, Hakan, Araujo, Mercedes Colorado, Itäla-Remes, Maija, Orchard, Kim, Isaksson, Cecilia, Bethge, Wolfgang, Martin, Hans, Aljurf, Mahmoud, Faber, Edgar, Caballero, Dolores, Zák, Pavel, Leleu, Xavier, Bay, Jacques-Olivier, Rohrlich, Pierre-Simon, Kröger, Nicolaus, Huynh, Anne, Schäfer-Eckart, Kerstin, Milpied, Noel, Lenhoff, Stig, Ho, Aloysius, López, Jose Luis Bello, Mordini, Nicola, Lioure, Bruno, Halaburda, Kazimierz, Olivieri, Attilio, Gedde-Dahl, Tobias, Protheroe, Rachel, Tischer, Johanna, Klammer, Matthias, Clausen, Johannes, Potter, Victoria, Ladetto, Marco, Tilly, Herve, Deconinck, Eric, Brecht, Arne, Müller, Lutz Peter, Heinicke, Thomas, Carrete, Juan Pio Torres, Bazarbachi, Ali, Reményi, Péter, Rubio, Marie Thérèse, Fanin, Renato, Pérez-Simón, Jose Antonio, Niels, Murawski, Diez-Martin, J., Arat, Mutlu, Hermine, Olivier, Socié, Gerard, Cornelissen, Jan, Santarone, Stella, Guyotat, Denis, Bulabois, Claude Eric, Bernasconi, Paolo, Johansson, Jan-Erik, Vrhovac, Radovan, Greinix, Hildegard, Lorenzo, José Luis López, Apte, Shashikant, Craddock, Charles, Kobbe, Guido, Zahrani, Mohsen Al, Dreger, Peter, Lange, Andrzej, Tbakhi, Abdelghani, Meijer, Ellen, Llamas, Carlos Vallejo, Santasusana, Josep Maria Ribera, Corradini, Paolo, Benedetti, Fabio, Rambaldi, Alessandro, Gandemer, Virginie, Malfuson, Jean-Valère, Kaare, Ain, Risitano, Antonio, Petrini, Mario, Selleri, Carmine, Wu, Depei, Hematology, CCA - Cancer Treatment and quality of life, Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, and Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
medicine.medical_specialty, Transplantation Conditioning, MESH: Busulfan, Medizin, MESH: Graft vs Host Disease, Graft vs Host Disease, [SDV.CAN]Life Sciences [q-bio]/Cancer, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Busulfan, MESH: Hematopoietic Stem Cell Transplantation, MESH: Transplantation Conditioning, Retrospective Studies, Transplantation, Acute leukemia, MESH: Humans, MESH: Middle Aged, business.industry, Hazard ratio, Hematopoietic Stem Cell Transplantation, Myeloid leukemia, MESH: Retrospective Studies, Retrospective cohort study, Hematology, Middle Aged, Total body irradiation, Fludarabine, Leukemia, Myeloid, Acute, Regimen, 030220 oncology & carcinogenesis, MESH: Vidarabine, [SDV.IMM]Life Sciences [q-bio]/Immunology, MESH: Leukemia, Myeloid, Acute, business, MESH: Whole-Body Irradiation, Vidarabine, Whole-Body Irradiation, 030215 immunology, medicine.drug
Abstract

International audience; The optimal conditioning for patients with acute myeloid leukemia in first complete remission treated with allogeneic hematopoietic cell transplantation (allo-HCT) has not been defined so far. In this retrospective study, we compared two "reduced-toxicity" regimens: intravenous busulfan at a total dose of 9.6 mg/kg (3 days) + fludarabine (Bu3/Flu) and total body irradiation at a dose of 8 Gy + fludarabine (TBI8Gy/Flu). In the entire study cohort (n = 518), the probabilities of overall survival (OS), leukemia-free survival (LFS), relapse and non-relapse mortality (NRM) at 2 years for Bu3/Flu and TBI8Gy/Flu were 62% vs. 72.5% (p = 0.051), 59.5% vs. 65% (p = 0.15), 30% vs. 20% (p = 0.01), and 10% vs. 14% (p = 0.18), respectively. In multivariate model for patients

Published
2021
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2. Autologous stem cell transplantation for progressive systemic sclerosis: a prospective non-interventional study from the European Society for Blood and Marrow Transplantation Autoimmune Disease Working Party

Author

Henes, J., Oliveira, M.C., Labopin, M., Badoglio, M., Scherer, H.U., Papa, N. del, Daikeler, T., Schmalzing, M., Schroers, R., Martin, T., Pugnet, G., Simoes, B., Michonneau, D., Marijt, E.W.A., Lioure, B., Bay, J.O., Snowden, J.A., Rovira, M., Huynh, A., Onida, F., Kanz, L., Marjanovic, Z., Farge, D., NISSC1 Members, University of São Paulo (USP), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre International des greffes [CHU Saint-Antoine] (EBMT), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Leiden University Medical Center (LUMC), University of Basel (Unibas), CHU Strasbourg, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Clermont-Ferrand, Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), and Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico

Subjects
Adult, medicine.medical_specialty, Transplantation Conditioning, Cyclophosphamide, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Aucun, Hematopoietic stem cell transplantation, Transplantation, Autologous, MESH: Scleroderma, Systemic, Article, Autoimmune Diseases, 03 medical and health sciences, 0302 clinical medicine, Autologous stem-cell transplantation, Bone Marrow, MESH: Autoimmune Diseases, Internal medicine, Clinical endpoint, Humans, Medicine, Prospective Studies, Progression-free survival, MESH: Hematopoietic Stem Cell Transplantation, MESH: Transplantation Conditioning, Aged, MESH: Aged, 030203 arthritis & rheumatology, MESH: Humans, Scleroderma, Systemic, business.industry, Hazard ratio, Hematopoietic Stem Cell Transplantation, MESH: Cyclophosphamide, MESH: Adult, Hematology, TRANSPLANTE AUTÓLOGO, MESH: Transplantation, Autologous, MESH: Prospective Studies, 3. Good health, Transplantation, MESH: Scleroderma, Diffuse, 030220 oncology & carcinogenesis, Scleroderma, Diffuse, MESH: Bone Marrow, Stem cell, business, medicine.drug
Abstract

Three randomized controlled trials in early severe systemic sclerosis demonstrated that autologous hematopoietic stem cell transplantation was superior to standard cyclophosphamide therapy. This European Society for Blood and Marrow Transplantation multicenter, prospective, non-interventional study was designed to further decipher efficacy and safety of this procedure for severe systemic sclerosis patients in real-life practice and to search for prognostic factors. All consecutive adult patients with systemic sclerosis undergoing a first autologous hematopoietic stem cell transplant between December 2012 and February 2016 were prospectively included in the study. The primary endpoint was progression-free survival. Secondary endpoints were overall survival, non-relapse mortality, response and incidence of progression. Eighty patients with systemic sclerosis were included. The median duration of the follow-up was 24 (range, 6-57) months after stem cell transplantation using cyclophosphamide plus antithymocyte globulin conditioning for all, with CD34+ selection in 35 patients. At 2 years, the progression- free survival rate was 81.8%, the overall survival rate was 90%, the response rate was 88.7% and the incidence of progression was 11.9%. The 100-day non-relapse mortality rate was 6.25% (n=5) with four deaths from cardiac events, including three due to cyclophosphamide toxicity. Modified Rodnan skin score and forced vital capacity improved with time (P24 and older age at transplantation were associated with lower progression-free survival (hazard ratios 3.32 and 1.77, respectively). CD34+-cell selection was associated with better response (hazard ratio 0.46). This study confirms the efficacy of autologous stem cell transplantation, using nonmyeloablative conditioning, in real-life practice for severe systemic sclerosis. Careful cardio-pulmonary assessment to identify organ involvement at the time of the patient’s referral, reduced cyclophosphamide doses and CD34+-cell selection may improve outcomes. The study was registered at ClinicalTrials.gov: NCT02516124.

Published
2021
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3. Risk factors for a severe form of COVID‐19 after allogeneic haematopoietic stem cell transplantation: a Société Francophone de Greffe de Moelle et de Thérapie cellulaire (SFGM‐TC) multicentre cohort study

Author

Stephanie Nguyen-Quoc, Hélène Salvator, Catherine Paillard, Michael Loschi, Jacques-Olivier Bay, Marie Robin, Yves Beguin, Marie-Thérèse Rubio, Ana Berceanu, Marie-Laure Chabi, Constance Xhaard, Aliénor Xhaard, Patrice Ceballos, Bénédicte Bruno, Maud D'Aveni, Jean-Hugues Dalle, Xavier Poiré, Tereza Coman, Karin Bilger, Yves Chalandon, Service d'Hématologie-Greffe, Hôpital Saint-Louis, Université Paris Diderot, Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de pneumologie [Hôpital Foch], Hôpital Foch [Suresnes], Service d'Hématologie, Institut Gustave Roussy, Université de Liège, Hôpitaux Universitaires de Genève (HUG), Service d'Hématologie, Bruxelles, Service d'Hématologie, CHU Nice, Service d'Hématologie Pédiatrique, CHRU Strasbourg, Service d'Hématologie Pédiatrique, CHU Lille, Service d'Hématologie, CHU Montpellier, 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), Service d'Hématologie, CHRU Strasbourg, Service d’Hématologie Biologique [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Service d'Hématologie clinique [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'Hématologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Laboratoire Énergies et Mécanique Théorique et Appliquée (LEMTA ), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Centre du cancer, and UCL - (SLuc) Service d'hématologie

Subjects
Transplantation Conditioning, COVID-19 / diagnostic imaging, MESH: Allografts, Kaplan-Meier Estimate, Thrombocytopenia / etiology, Cohort Studies, 0302 clinical medicine, MESH: Risk Factors, Risk Factors, MESH: Child, MESH: COVID-19, Transplantation Conditioning / adverse effects, Child, MESH: Cohort Studies, ComputingMilieux_MISCELLANEOUS, MESH: Transplantation Conditioning, COVID-19 / complications, MESH: Aged, ddc:616, MESH: Middle Aged, Hematopoietic Stem Cell Transplantation, Hematology, Middle Aged, Allografts, 3. Good health, Haematopoiesis, COVID-19 / mortality, MESH: Young Adult, 030220 oncology & carcinogenesis, Child, Preschool, MESH: Immunosuppressive Agents, France, Stem cell, Immunosuppressive Agents, Cohort study, Adult, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Adolescent, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Immunosuppressive Agents / adverse effects, 03 medical and health sciences, Young Adult, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, France / epidemiology, Correspondence, medicine, Humans, MESH: SARS-CoV-2, MESH: Hematopoietic Stem Cell Transplantation, MESH: Kaplan-Meier Estimate, MESH: Thrombocytopenia, Aged, Retrospective Studies, MESH: Adolescent, Gynecology, MESH: Humans, business.industry, SARS-CoV-2, MESH: Child, Preschool, Hematopoietic Stem Cell Transplantation / adverse effects, COVID-19, MESH: Adult, MESH: Retrospective Studies, Retrospective cohort study, Thrombocytopenia, MESH: France, Transplantation, business, 030215 immunology
Abstract

International audience

Published
2021
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4. High-dose therapy followed by autologous purged stem cell transplantation and doxorubicin-based chemotherapy in patients with advanced follicular lymphoma: a randomized multicenter study by the GOELAMS with final results after a median follow-up of 9 years

Author

Emmanuel Gyan, Christian Berthou, Steven Le Gouill, Philippe Colombat, Roselyne Delepine, Jean-Pierre Vilque, Philippe Quittet, Bernard Desablens, Antoine Thyss, Philippe Bertrand, Eric Deconinck, Jean-François Ramée, Vincent Delwail, Patrick Michenet, Nina Arakelyan, Remi Gressin, Noel Milpied, Jérôme Jaubert, Hervé Maisonneuve, Cécile Moluçon-Chabrot, Charles Foussard, Service d'hématologie [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Service d'hématologie, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Hôtel Dieu, Département de biostatistiques, Faculté de Médecine de Tours, Service de pathologie, CHU Orléans, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre hospitalier La Roche-Sur-Yon, Service Hématologie, Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Hôpital Jean Bernard, CHU Grenoble, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Laboratoire d'Hématologie [CHU Amiens], CHU Amiens-Picardie, CHU Saint-Etienne, Clinique Catherine de Sienne, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), CHU Clermont-Ferrand, CHU Bordeaux [Bordeaux], Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Groupe Ouest-Est des Leucémies et des Autres Maladies du Sang (GOELAMS), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), and Saas, Philippe

Subjects
Male, Oncology, Transplantation Conditioning, MESH: Immunotherapy, medicine.medical_treatment, Follicular lymphoma, Hematopoietic stem cell transplantation, Biochemistry, MESH: Lymphoma, Follicular, 0302 clinical medicine, Autologous stem-cell transplantation, Lymphoma, Follicular, MESH: Transplantation Conditioning, MESH: Middle Aged, Bone Marrow Purging, Neoplasms, Second Primary, MESH: Follow-Up Studies, Hematology, Middle Aged, Total body irradiation, MESH: Transplantation, Autologous, 3. Good health, Survival Rate, 030220 oncology & carcinogenesis, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Immunotherapy, MESH: Stem Cell Transplantation, MESH: Whole-Body Irradiation, MESH: Bone Marrow Purging, Whole-Body Irradiation, medicine.drug, Adult, MESH: Myeloablative Agonists, MESH: Neoplasms, Second Primary, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, Adolescent, MESH: Survival Rate, Cyclophosphamide, Immunology, Transplantation, Autologous, Disease-Free Survival, 03 medical and health sciences, Internal medicine, medicine, Humans, Survival rate, MESH: Adolescent, Chemotherapy, MESH: Humans, business.industry, MESH: Cyclophosphamide, MESH: Adult, Cell Biology, Myeloablative Agonists, medicine.disease, MESH: Male, Surgery, Transplantation, MESH: Disease-Free Survival, business, MESH: Female, Follow-Up Studies, Stem Cell Transplantation, 030215 immunology
Abstract

Autologous stem cell transplantation (ASCT) as first-line therapy for follicular lymphoma (FL) remains controversial. The multicenter study randomized 172 patients with untreated FL for either immunochemotherapy or high-dose therapy (HDT) followed by purged ASCT. Conditioning was performed with total body irradiation (TBI) and cyclophosphamide. The 9-year overall survival (OS) was similar in the HDT and conventional chemotherapy groups (76% and 80%, respectively). The 9-year progression-free survival (PFS) was higher in the ASCT than the chemotherapy group (64% vs 39%; P = .004). A PFS plateau was observed in the HDT group after 7 years. On multivariate analysis, OS and PFS were independently affected by the per-formance status score, the number of nodal areas involved, and the treatment group. Secondary malignancies were more frequent in the HDT than in the chemotherapy group (6 secondary myelodysplastic syndrome/acute myeloid leukemia and 6 second solid tumor cancers vs 1 acute myeloid leukemia, P = .01). The occurrence of a PFS plateau suggests that a subgroup of patients might have their FL cured by ASCT. However, the increased rate of secondary malignancies may discourage the use of purged ASCT in combination with TBI as first-line treatment for FL. This trial has been registered with ClinicalTrials.gov under identifier NCT00696735.

Published
2009
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5. Stable long-term pulmonary function after fludarabine, antithymocyte globulin and i.v. BU for reduced-intensity conditioning allogeneic SCT

Author

P. Germaud, Mohamad Mohty, Patricia Lemarchand, Florent Malard, Béatrice Delasalle, Philippe Moreau, Patrice Chevallier, Thierry Guillaume, Arnaud Chambellan, Jacques Delaunay, S. Dirou, Service de Pneumologie, Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Hôpital Guillaume-et-René-Laennec [Saint-Herblain]-Institut du Thorax, 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 Hématologie Clinique, Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), FM was supported by educational grants from the 'Association for Training, Education and Research in Hematology, Immunology and Transplantation' (ATERHIT). We also thank the 'Re'gion Pays de Loire', the 'Association pour la Recherche sur le Cancer', the 'Fondation de France', the 'Fondation contre la Leuce' mie', the 'Agence de Biome' decine', the 'Association Cent pour Sang la Vie', the 'Association Laurette Fuguain', the IRGHET and the 'Ligue Contre le Cancer' (Comite' s Grand-Ouest) for their generous and continuous support for our clinical and basic research work. Our group is supported by several grants from the French National Cancer Institute (PHRC, INCa to MM)., Lemarchand, Patricia, Université de Nantes (UN)-Institut du Thorax-Centre hospitalier universitaire de Nantes (CHU Nantes)-Hôpital Guillaume-et-René-Laennec [Saint-Herblain], Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), and Université de Nantes (UN)-Université de Nantes (UN)

Subjects
Lung Diseases, Male, Vital capacity, Transplantation Conditioning, MESH: Administration, Intravenous, MESH: Busulfan, MESH: Respiratory Function Tests, Gastroenterology, Pulmonary function testing, MESH: Lung Diseases, 0302 clinical medicine, MESH: Antilymphocyte Serum, hemic and lymphatic diseases, Medicine, Cumulative incidence, MESH: Transplantation Conditioning, MESH: Aged, education.field_of_study, MESH: Middle Aged, pulmonary function, Hematology, MESH: Follow-Up Studies, Middle Aged, MESH: Hematologic Diseases, Fludarabine, Respiratory Function Tests, MESH: Young Adult, 030220 oncology & carcinogenesis, MESH: Vidarabine, Administration, Intravenous, Female, MESH: Immunosuppressive Agents, MESH: Stem Cell Transplantation, Immunosuppressive Agents, Vidarabine, medicine.drug, Adult, medicine.medical_specialty, MESH: Myeloablative Agonists, Population, [SDV.BC]Life Sciences [q-bio]/Cellular Biology, Lymphocyte Depletion, Article, 03 medical and health sciences, FEV1/FVC ratio, Young Adult, Internal medicine, MESH: Transplantation, Homologous, Humans, Transplantation, Homologous, education, Busulfan, [SDV.BC] Life Sciences [q-bio]/Cellular Biology, Aged, Antilymphocyte Serum, Retrospective Studies, MESH: Lymphocyte Depletion, Transplantation, MESH: Humans, business.industry, MESH: Adult, MESH: Retrospective Studies, Myeloablative Agonists, Hematologic Diseases, MESH: Male, Surgery, ATG, Regimen, business, MESH: Female, reduced-intensity conditioning, 030215 immunology, Follow-Up Studies, Stem Cell Transplantation
Abstract

International audience; Lung function decline is a well-recognized complication following allogeneic SCT (allo-SCT). Reduced-intensity conditioning (RIC) and in vivo T-cell depletion by administration of antithymocyte globulin (ATG) may have a protective role in the occurrence of late pulmonary complications. This retrospective study reported the evolution of lung function parameters within the first 2 years after allo-SCT in a population receiving the same RIC regimen that included fludarabine and i.v. BU in combination with low-dose ATG. The median follow-up was 35.2 months. With a median age of 59 years at the time of transplant, at 2 years, the cumulative incidences of non-relapse mortality was as low as 9.7%. The cumulative incidence of relapse was 33%. At 2 years, the cumulative incidences of extensive chronic GVHD (cGVHD) and of pulmonary cGVHD were 23.1% and 1.9%, respectively. The cumulative incidences of airflow obstruction and restrictive pattern were 3.8% and 9.6%, respectively. Moreover, forced expiratory volume (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio remained stable from baseline up to 2 years post transplantation (P=0.26, P=0.27 and P=0.07, respectively). These results correspond favorably with the results obtained with other RIC regimens not incorporating ATG, and suggest that ATG may have a protective pulmonary role after allo-SCT.

Published
2014
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6. Allogeneic hematopoietic cell transplantation for advanced polycythemia vera and essential thrombocythemia

Author

Matt Kalaycio, Mukta Arora, Joseph H. Antin, Joerg Halter, Richard T. Maziarz, Wael Saber, Matthew Carabasi, Kwang Woo Ahn, Harry C. Schouten, Vikas Gupta, Ann E. Woolfrey, Mahmoud Aljurf, Brian J. Bolwell, David L. Porter, Ian D. Lewis, Xiaochun Zhu, H. Joachim Deeg, Jean-Yves Cahn, Mary M. Horowitz, Philip L. McCarthy, Gregory A. Hale, Bipin N. Savani, Biju George, Mehdi Hamadani, Steven Z. Pavletic, Jorge E. Cortes, Ed Copelan, Baldeep Wirk, Karen K. Ballen, Mayo Clinic, the Cleveland Clinic Foundation, Cleveland Clinic, St Jude Children's Research Hospital, TheREx, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), University Hospital Basel [Basel], Roswell Park Cancer Institute [Buffalo], Division of Haematology, University of Toronto-Princess Margaret Hospital, University of Toronto, Institut d'Astrophysique de Paris (IAP), Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC), Interne Geneeskunde, and RS: GROW - School for Oncology and Reproduction

Subjects
Male, Transplantation Conditioning, Neutrophils, medicine.medical_treatment, Graft vs Host Disease, Hematopoietic stem cell transplantation, PV, MESH: Neutrophils, Gastroenterology, MESH: Polycythemia Vera, 0302 clinical medicine, Polycythemia vera, Recurrence, Cumulative incidence, Longitudinal Studies, MESH: Longitudinal Studies, Polycythemia Vera, MESH: Transplantation Conditioning, MESH: Middle Aged, Hematopoietic Stem Cell Transplantation, Hematology, Middle Aged, 3. Good health, MESH: Splenomegaly, 030220 oncology & carcinogenesis, MESH: Survival Analysis, Acute Disease, Splenectomy, MESH: Acute Disease, Female, Thrombocythemia, Essential, Adult, medicine.medical_specialty, MESH: Myeloablative Agonists, Platelet Engraftment, MESH: Graft vs Host Disease, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Splenectomy, Article, 03 medical and health sciences, Internal medicine, medicine, MESH: Transplantation, Homologous, Humans, Transplantation, Homologous, Myelofibrosis, MESH: Hematopoietic Stem Cell Transplantation, Transplantation, Neutrophil Engraftment, MESH: Humans, Essential thrombocythemia, business.industry, MESH: Adult, Myeloablative Agonists, medicine.disease, Survival Analysis, MESH: Male, Surgery, MESH: Recurrence, Splenomegaly, MESH: Thrombocythemia, Essential, business, ET, MESH: Female, 030215 immunology
Abstract

Allogeneic hematopoietic cell transplantation (HCT) is curative for selected patients with advanced essential thrombocythemia (ET) or polycythemia vera (PV). From 1990 to 2007, 75 patients with ET (median age 49 years) and 42 patients with PV (median age 53 years) underwent transplantations at the Fred Hutchinson Cancer Research Center (FHCRC; n = 43) or at other Center for International Blood and Marrow Transplant Research (CIBMTR) centers (n = 74). Thirty-eight percent of the patients had splenomegaly and 28% had a prior splenectomy. Most patients (69% for ET and 67% for PV) received a myeloablative (MA) conditioning regimen. Cumulative incidence of neutrophil engraftment at 28 days was 88% for ET patients and 90% for PV patients. Acute graft-versus-host disease (aGVHD) grades II to IV occurred in 57% and 50% of ET and PV patients, respectively. The 1-year treatment-related mortality (TRM) was 27% for ET and 22% for PV. The 5-year cumulative incidence of relapse was 13% for ET and 30% for PV. Five-year survival/progression-free survival (PFS) was 55%/47% and 71%/48% for ET and PV, respectively. Patients without splenomegaly had faster neutrophil and platelet engraftment, but there were no differences in TRM, survival, or PFS. Presence of myelofibrosis (MF) did not affect engraftment or TRM. Over 45% of the patients who undergo transplantations for ET and PV experience long-term PFS. American Society for Blood and Marrow Transplantation.

Published
2012
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7. Reduced intensity conditioning is superior to nonmyeloablative conditioning for older chronic myelogenous leukemia patients undergoing hematopoietic cell transplant during the tyrosine kinase inhibitor era

Author

Ravi Vij, Mahmoud Aljurf, Joseph Pidala, H. Jean Khoury, Richard F. Olsson, Erica D. Warlick, Ian D. Lewis, Matthew D. Seftel, Bipin N. Savani, Brenda W. Cooper, Mitchell S. Cairo, Michael A. Pulsipher, Gorgun Akpek, Tanya L. Pedersen, Andrew S. Artz, Martin S. Tallman, Jean-Yves Cahn, Lars Vindeløv, Abhinav Deol, Celaettin Ustun, Vikas Gupta, Marcos de Lima, Sergio Giralt, Kwang Woo Ahn, Hillard M. Lazarus, Holbrook E Kohrt, Gérard Socié, Yi-Bin Chen, Daniel J. Weisdorf, TheREx, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Division of Haematology, University of Toronto-Princess Margaret Hospital, University of Toronto, Service d'hématologie greffe [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
Male, Transplantation Conditioning, Clinical Trials and Observations, medicine.medical_treatment, MESH: Piperazines, Graft vs Host Disease, Hematopoietic stem cell transplantation, Biochemistry, Gastroenterology, Piperazines, Tyrosine-kinase inhibitor, MESH: Unrelated Donors, 0302 clinical medicine, hemic and lymphatic diseases, MESH: Protein Kinase Inhibitors, MESH: Transplantation Conditioning, MESH: Aged, MESH: Middle Aged, Incidence (epidemiology), Hematopoietic Stem Cell Transplantation, Hematology, Middle Aged, Protein-Tyrosine Kinases, 3. Good health, Survival Rate, 030220 oncology & carcinogenesis, Benzamides, Cohort, Imatinib Mesylate, Female, Unrelated Donors, MESH: Neoplasm Recurrence, Local, medicine.drug, Adult, medicine.medical_specialty, MESH: Survival Rate, medicine.drug_class, Immunology, MESH: Graft vs Host Disease, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Protein-Tyrosine Kinases, 03 medical and health sciences, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Internal medicine, medicine, MESH: Transplantation, Homologous, Humans, Transplantation, Homologous, Protein Kinase Inhibitors, Survival rate, MESH: Hematopoietic Stem Cell Transplantation, Aged, MESH: Humans, business.industry, Imatinib, MESH: Adult, Cell Biology, medicine.disease, MESH: Male, Surgery, Pyrimidines, MESH: Leukemia, Myelogenous, Chronic, BCR-ABL Positive, MESH: Pyrimidines, Neoplasm Recurrence, Local, business, MESH: Female, 030215 immunology, Chronic myelogenous leukemia
Abstract

Tyrosine kinase inhibitors (TKIs) and reduced intensity conditioning (RIC)/nonmyeloablative (NMA) conditioning hematopoietic cell transplants (HCTs) have changed the therapeutic strategy for chronic myelogenous leukemia (CML) patients. We analyzed post-HCT outcomes of 306 CML patients reported to the Center for International Blood and Marrow Transplant Research aged 40 years and older undergoing RIC/NMA HCT from 2001 to 2007: 117 (38%) aged 40 to 49 years, 119 (39%) 50 to 59 years, and 70 (23%) 60 years or older. The majority (74%) had treatment with imatinib before HCT. At HCT, most patients aged 40 to 49 years were in chronic phase (CP) 1 (74%), compared with 31% aged 60 years or older. Siblings were donors for 56% aged 40 to 49 years; older cohorts had more unrelated donors. The majority received peripheral blood grafts and RIC across all age groups. 3 year overall survival (54%, 52%, and 41%), day + 100 grade II-IV acute GVHD (26%, 32%, and 32%), chronic GVHD (58%, 51%, and 43%), and 1-year treatment-related mortality (18%, 20%, and 13%) were similar across ages. The 3-year relapse incidence (36%, 43%, and 66%) and disease-free survival (35%, 32%, and 16%) were inferior in the oldest cohort. Importantly, for CP1 patients, relapse and disease-free survival were similar across age cohorts. Allogeneic RIC HCT for older patients with CML can control relapse with acceptable toxicity and survival in TKI-exposed CML, especially if still in CP1.

Published
2012
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8. Early matched sibling hematopoietic cell transplantation for adult AML in first remission using an age-adapted strategy: long-term results of a prospective GOELAMS study

Author

Bruno Lioure, Odile Blanchet, Christian Berthou, Mario Ojeda-Uribe, Jean-Luc Harousseau, Didier Bouscary, Martin Carre, Marie C. Béné, Fabrice Larosa, Mathilde Hunault, Isabelle Luquet, Luc Fornecker, Patrice Chevallier, Brigitte Witz, Norbert Ifrah, Didier Blaise, Pascale Cornillet-Lefebvre, Thierry Lamy, Jérôme Cornillon, Anne Huynh, Martine Delain, Arnaud Pigneux, Edouard Randriamalala, Nathalie Fegueux, Jean-Yves Cahn, Service d'onco-hématologie, CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Service d'Hématologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Laboratoire d'Hématologie [Purpan], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Service d'hématologie et oncologie médicale, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie-Université de Montpellier (UM), Hôpital Haut-Lévêque, Université Sciences et Technologies - Bordeaux 1-CHU Bordeaux [Bordeaux], Institut de Cancérologie de la Loire Lucien Neuwirth, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Laboratoire d'hématologie, Centre Hospitalier Universitaire de Reims (CHU Reims), 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), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'hématologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Microenvironnement et cancer (MiCa), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, Service d'hématologie [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service d'hématologie clinique [Avicenne], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13)-Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), TheREx, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Service Hématologie - IUCT-Oncopole [CHU Toulouse], Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle IUCT [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université Sciences et Technologies - Bordeaux 1 (UB)-CHU Bordeaux [Bordeaux], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], and Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, MESH: Remission Induction, Transplantation Conditioning, Myeloid, medicine.medical_treatment, Graft vs Host Disease, Kaplan-Meier Estimate, Hematopoietic stem cell transplantation, MESH: Peripheral Blood Stem Cell Transplantation, Biochemistry, MESH: Proportional Hazards Models, 0302 clinical medicine, hemic and lymphatic diseases, Antineoplastic Combined Chemotherapy Protocols, Medicine, Cumulative incidence, MESH: Incidence, MESH: Bone Marrow Transplantation, Bone Marrow Transplantation, MESH: Transplantation Conditioning, MESH: Middle Aged, Incidence, Incidence (epidemiology), Remission Induction, Hematopoietic Stem Cell Transplantation, Hematology, Middle Aged, 3. Good health, Leukemia, Myeloid, Acute, Leukemia, MESH: Antineoplastic Combined Chemotherapy Protocols, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Female, MESH: Leukemia, Myeloid, Acute, medicine.medical_specialty, Immunology, MESH: Graft vs Host Disease, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, Internal medicine, Humans, MESH: Hematopoietic Stem Cell Transplantation, MESH: Kaplan-Meier Estimate, Proportional Hazards Models, Peripheral Blood Stem Cell Transplantation, MESH: Humans, business.industry, Proportional hazards model, Siblings, Cell Biology, medicine.disease, Confidence interval, MESH: Male, Surgery, MESH: Siblings, Transplantation, business, MESH: Female, 030215 immunology
Abstract

The LAM2001 phase 3 trial, involving 832 patients with acute myeloid leukemia (AML; median: 46 years) proposed HLA-identical sibling allograft HSCT for all patients with an identified donor. The trial compared reduced-intensity conditioning (RIC) for patients older than 50 years of age (N = 47) and myeloablative conditioning for younger patients (N = 117). BM HSCT was performed in the younger patients, while the older ones received a consolidation course, followed by peripheral blood allo-HSCT using RIC. The incidence of grade II-IV acute GVHD, was 51.9% (95% confidence interval [CI]: 42.1-61.8) and 11.3% (1.6-21.2) after myeloablative or RIC, respectively (P < .0001) and that of chronic GVHD 45.8% (95% CI: 34.8-56.7) and 41.7% (24.7-58.6; NS). Cumulative incidence of nonrelapse mortality at 108 months was 15.8% (95% CI: 9.8-23.2) for myeloablative, and 6.5% (0.2-16.2) for RIC (NS). CI of relapse at 108 months was 21.7% (95% CI: 13.9-28.6) and 28.6% (16.5-43.4; NS). Overall survival at 108 months was 63.4% (95% CI: 54.6-72.2) and 65.8% (52.2-72.2), respectively, after myeloablative or RIC (NS). RIC peripheral blood stem cell allo-HSCT is prospectively feasible for patients between the ages of 51 and 60 years without excess of relapse or nonrelapse mortality, and compares favorably with myeloablative marrow allo-HSCT proposed to younger patients. This study was registered at clinicaltrials.gov as no. NCT01015196.

Published
2012
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9. Reduced-intensity conditioning before allogeneic hematopoietic stem cell transplantation in patients over 60 years: a report from the SFGM-TC

Author

Sylvie François, Agnes Buzyn, Mauricette Michallet, Nicole Gratecos, Didier Blaise, François Guilhot, Richard Szydlo, Reza Tabrizi, Mohamad Mohty, Gérard Socié, Nathalie Contentin, Madalina Uzunov, Nathalie Fegueux, Jacques-Olivier Bay, Patrice Chevallier, Anne Huynh, Simona Lapusan, Jean-Yves Cahn, Ibrahim Yakoub-Agha, Sébastien Maury, Hôpital Haut-Lévêque, Université Sciences et Technologies - Bordeaux 1-CHU Bordeaux [Bordeaux], Service d'hématologie [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service d'hématologie et oncologie médicale, Hôpital Lapeyronie-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), Institut de Chimie des Milieux et Matériaux de Poitiers (IC2MP), Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université de Poitiers-Institut de Chimie du CNRS (INC), Service Hématologie, Centre Hospitalier Universitaire de Nice (CHU Nice), TheREx, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Hematology, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-CHU Grenoble, Service d'hématologie greffe [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), UAM Allogreffes de CSH, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire d'Hématologie [Purpan], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Unité de transplantation médullaire et laboratoire d'oncologie moléculaire, Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER-UNICANCER, Institut Cochin (UMR_S567 / UMR 8104), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), 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), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Université Montpellier 1 ( UM1 ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Lapeyronie, Institut de Chimie des Milieux et Matériaux de Poitiers ( IC2MP ), Université de Poitiers-Centre National de la Recherche Scientifique ( CNRS ), CHU Nice, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications [Grenoble] ( TIMC-IMAG ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ) -Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ) -Hematology, Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-CHU Grenoble, Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Université Toulouse III - Paul Sabatier ( UPS ), CRLCC Jean Perrin, Institut Cochin ( UMR_S567 / UMR 8104 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Centre de Recherche en Cancérologie / Nantes - Angers ( CRCNA ), CHU Angers-Centre hospitalier universitaire de Nantes ( CHU Nantes ) -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, Université de Poitiers-Centre National de la Recherche Scientifique (CNRS), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Hematology, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5), Centre de Recherche en Cancérologie / Nantes - Angers (CRCNA), Centre hospitalier universitaire de Nantes (CHU Nantes)-Faculté de Médecine d'Angers-Centre Hospitalier Universitaire d'Angers (CHU Angers), and PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Centre National de la Recherche Scientifique (CNRS)-Hôpital Laennec-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôtel-Dieu de Nantes

Subjects
Male, MESH: Tissue Donors, Multivariate analysis, Transplantation Conditioning, MESH : Retrospective Studies, MESH : Transplantation Conditioning, medicine.medical_treatment, MESH : Aged, Hematopoietic stem cell transplantation, Disease, Allo-HSCT, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, Medicine, MESH : Female, MESH : Tissue Donors, MESH: Transplantation Conditioning, MESH: Aged, MESH: Middle Aged, Age Factors, Hematopoietic Stem Cell Transplantation, Hematology, MESH: Follow-Up Studies, Middle Aged, SFGM-TC, MESH : Survival Rate, MESH : Risk Factors, Tissue Donors, 3. Good health, Survival Rate, 030220 oncology & carcinogenesis, Reduced Intensity Conditioning, Hematologic Neoplasms, MESH : Disease-Free Survival, Female, MESH : Hematologic Neoplasms, medicine.medical_specialty, MESH: Survival Rate, MESH : Transplantation, Homologous, MESH : Male, [SDV.CAN]Life Sciences [q-bio]/Cancer, Disease-Free Survival, 03 medical and health sciences, Age, MESH : Hematopoietic Stem Cell Transplantation, Internal medicine, MESH: Transplantation, Homologous, Humans, Transplantation, Homologous, MESH : Middle Aged, In patient, MESH: Hematopoietic Stem Cell Transplantation, Aged, Retrospective Studies, MESH: Age Factors, Transplantation, MESH: Humans, business.industry, MESH : Humans, RIC, Complete remission, MESH : Follow-Up Studies, MESH: Retrospective Studies, Confidence interval, MESH: Male, Surgery, Elderly patients, Relative risk, MESH: Disease-Free Survival, MESH : Age Factors, business, MESH: Female, 030215 immunology, Follow-Up Studies, MESH: Hematologic Neoplasms
Abstract

International audience; This retrospective multicenter report assessed the outcome of 600 patients with hematologic diseases older than 60 years who received reduced-intensity conditioning (RIC) allogeneic hematopoietic stem cell transplantation (allo-HSCT), with the specific aim to compare outcomes of patients between 60 and 65 years old (N = 493) with those older than 65 years (N = 107). Except for donor age, there were no significant differences between the groups regarding patients, diseases, and allo-HSCT characteristics. At time of RIC allo-HSCT, 276 patients (46%) were in complete remission. With a median follow-up of 22.8 and 23.7 months in the younger and the older groups, respectively, 2-year relapse, nonrelapse mortality, disease-free survival, and overall survival rates were similar in both groups (29.6% vs. 20.4%; 29.9% vs. 34.6%; 40.6% vs. 46.7%; 49.2% vs. 50.2%, respectively; P = NS for all comparisons). In a Cox multivariate analysis, after adjustment for disease and transplant factors, age per se was not an adverse factor for survival (relative risk = 1.08; 95% confidence interval, 0.81-1.44, P = .62). We conclude that in selected patients, RIC allo-HSCT could be offered to patients over 65 years old.

Published
2012
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10. Risk factors for acute GVHD and survival after hematopoietic cell transplantation

Author

Vikas Gupta, Mary E.D. Flowers, Mukta Arora, Madan Jagasia, Alvaro Urbano-Ispizua, Stephanie J. Lee, Mei-Jie Zhang, Christopher Bredeson, Theresa Hahn, Philip L. McCarthy, Corey Cutler, Mark R. Litzow, Mitchell S. Cairo, Joseph H. Antin, Robert Peter Gale, Mary M. Horowitz, Steven Z. Pavletic, Nelson J. Chao, Jean-Yves Cahn, Michael Haagenson, Daniel J. Weisdorf, Brian J. Bolwell, Mayo Clinic, Department of Hematology, Hospital Universitario Virgen del Rocío [Sevilla], Medical College of Wisconsin, TheREx, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Vanderbilt University [Nashville], Division of Haematology, University of Toronto-Princess Margaret Hospital, University of Toronto, National Cancer Institute [Bethesda] (NCI-NIH), National Institutes of Health [Bethesda] (NIH), and Roswell Park Cancer Institute [Buffalo]

Subjects
Male, MESH: Tissue Donors, Transplantation Conditioning, Clinical Trials and Observations, medicine.medical_treatment, Graft vs Host Disease, Hematopoietic stem cell transplantation, Biochemistry, Gastroenterology, MESH: Unrelated Donors, 0302 clinical medicine, MESH: Risk Factors, Risk Factors, MESH: Child, hemic and lymphatic diseases, Child, MESH: Transplantation Conditioning, MESH: Aged, MESH: Middle Aged, Hematopoietic Stem Cell Transplantation, Hematology, Total body irradiation, Middle Aged, MESH: Infant, Tissue Donors, 3. Good health, Survival Rate, surgical procedures, operative, MESH: Young Adult, 030220 oncology & carcinogenesis, Child, Preschool, Histocompatibility, Hematologic Neoplasms, Acute Disease, MESH: Acute Disease, Female, Unrelated Donors, MESH: Whole-Body Irradiation, Whole-Body Irradiation, Adult, medicine.medical_specialty, MESH: Survival Rate, Adolescent, Immunology, MESH: Graft vs Host Disease, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, Young Adult, Internal medicine, MESH: Transplantation, Homologous, medicine, Transplantation, Homologous, Humans, Survival rate, MESH: Hematopoietic Stem Cell Transplantation, Aged, Retrospective Studies, MESH: Adolescent, MESH: Humans, business.industry, Siblings, MESH: Child, Preschool, Infant, MESH: Retrospective Studies, MESH: Adult, Cell Biology, medicine.disease, MESH: Male, MESH: Histocompatibility, MESH: Siblings, Surgery, Transplantation, Regimen, Graft-versus-host disease, business, MESH: Female, MESH: Hematologic Neoplasms, 030215 immunology
Abstract

Risk factors for acute GVHD (AGVHD), overall survival, and transplant-related mortality were evaluated in adults receiving allogeneic hematopoietic cell transplants (1999-2005) from HLA-identical sibling donors (SDs; n = 3191) or unrelated donors (URDs; n = 2370) and reported to the Center for International Blood and Marrow Transplant Research, Minneapolis, MN. To understand the impact of transplant regimen on AGVHD risk, 6 treatment categories were evaluated: (1) myeloablative conditioning (MA) with total body irradiation (TBI) + PBSCs, (2) MA + TBI + BM, (3) MA + nonTBI + PBSCs, (4) MA + nonTBI + BM, (5) reduced intensity conditioning (RIC) + PBSCs, and (6) RIC + BM. The cumulative incidences of grades B-D AGVHD were 39% (95% confidence interval [CI], 37%-41%) in the SD cohort and 59% (95% CI, 57%-61%) in the URD cohort. Patients receiving SD transplants with MA + nonTBI + BM and RIC + PBSCs had significantly lower risks of grades B-D AGVHD than patients in other treatment categories. Those receiving URD transplants with MA + TBI + BM, MA + nonTBI + BM, RIC + BM, or RIC + PBSCs had lower risks of grades B-D AGVHD than those in other treatment categories. The 5-year probabilities of survival were 46% (95% CI, 44%-49%) with SD transplants and 33% (95% CI, 31%-35%) with URD transplants. Conditioning intensity, TBI and graft source have a combined effect on risk of AGVHD that must be considered in deciding on a treatment strategy for individual patients.

Published
2012
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11. Retrospective study of allogeneic haematopoietic stem-cell transplantation for myelofibrosis

Author

Jérôme Cornillon, A. Cabrespine, J.-O. Bay, Bruno Cassinat, R. Peffault de Latour, Raphaël Porcher, Severine Lissandre, J.Y. Cahn, V. Cacheux, Gérard Socié, Marie Robin, TheREx, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Institut Mondor de Recherche Biomédicale (IMRB), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10

Subjects
Transplantation Conditioning, Graft vs Host Disease, Gastroenterology, 0302 clinical medicine, hemic and lymphatic diseases, Medicine, MESH: Transplantation Conditioning, MESH: Aged, Hematology, Leukemia, MESH: Middle Aged, Hematopoietic Stem Cell Transplantation, Middle Aged, 3. Good health, Fludarabine, Haematopoiesis, surgical procedures, operative, MESH: Young Adult, 030220 oncology & carcinogenesis, MESH: Survival Analysis, MESH: Primary Myelofibrosis, medicine.drug, Adult, medicine.medical_specialty, Adolescent, MESH: Graft vs Host Disease, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, Young Adult, Internal medicine, MESH: Leukemia, MESH: Transplantation, Homologous, Humans, Transplantation, Homologous, Myelofibrosis, Survival analysis, MESH: Hematopoietic Stem Cell Transplantation, Aged, Retrospective Studies, MESH: Adolescent, Transplantation, MESH: Humans, business.industry, Retrospective cohort study, MESH: Adult, MESH: Retrospective Studies, medicine.disease, Survival Analysis, Surgery, Graft-versus-host disease, Primary Myelofibrosis, business, 030215 immunology
Abstract

International audience; Allogeneic haematopoietic stem-cell transplantation (HSCT) is the only curative treatment for myelofibrosis. We retrospectively analyzed the outcome of patients who underwent allogeneic HSCT, 1994-2008, and the potential risk factors affecting non-relapse mortality (NRM), OS and relapse-free survival (RFS). A total of 39 patients, 15-65 (median 49) years old, diagnosed with primary (n=27) or secondary (n=12) myelofibrosis underwent HSCT (25 related and 14 unrelated). In ten patients, disease had transformed into acute leukaemia. Lille prognosis score was low for 9, intermediate for 16 and high for 14 patients. The conditioning regimen was myeloablative (MAC) for 15 and reduced-intensity (RIC) fludarabine-based for 24, with successful engraftment in 38 patients. A total of 31 patients developed grade I-IV GvHD; 19 developed chronic GvHD. The 3-year OS, RFS and NRM rates (95% confidence interval) were 60% (42-74), 54% (37-59) and 30% (30-45), respectively.

Published
2011
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12. Hematopoietic stem-cell transplantation for acute leukemia in relapse or primary induction failure

Author

Edward A. Copelan, Martin S. Tallman, Jean-Yves Cahn, Vikas Gupta, Michel Duval, Marcos de Lima, David A. Rizzieri, Bruce M. Camitta, John P. Klein, Wensheng He, David I. Marks, Armand Keating, Richard T. Maziarz, Mitchell S. Cairo, Rammurti T. Kamble, Kirk R. Schultz, Daniel J. Weisdorf, Mark R. Litzow, Gary J. Schiller, Hillard M. Lazarus, Institut Charles Sadron (ICS), Université de Strasbourg (UNISTRA)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Matériaux et nanosciences d'Alsace (FMNGE), Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), TheREx, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Hematology, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-CHU Grenoble, Division of Haematology, University of Toronto-Princess Margaret Hospital, University of Toronto, and Department of Medical Oncology and Hematology

Subjects
Male, Oncology, Cancer Research, Transplantation Conditioning, MESH: Treatment Failure, medicine.medical_treatment, Hematopoietic stem cell transplantation, 0302 clinical medicine, Recurrence, hemic and lymphatic diseases, MESH: Child, Treatment Failure, Child, MESH: Transplantation Conditioning, MESH: Treatment Outcome, MESH: Aged, Acute leukemia, MESH: Middle Aged, Hematopoietic Stem Cell Transplantation, Myeloid leukemia, Middle Aged, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Prognosis, MESH: Infant, 3. Good health, Leukemia, Myeloid, Acute, Leukemia, Treatment Outcome, surgical procedures, operative, MESH: Young Adult, Child, Preschool, 030220 oncology & carcinogenesis, MESH: Survival Analysis, Acute Disease, MESH: Acute Disease, Female, MESH: Leukemia, Myeloid, Acute, Adult, medicine.medical_specialty, Adolescent, Primary Induction Failure, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Prognosis, Young Adult, 03 medical and health sciences, Internal medicine, Original Reports, medicine, Humans, Survival analysis, MESH: Hematopoietic Stem Cell Transplantation, Aged, MESH: Adolescent, MESH: Precursor Cell Lymphoblastic Leukemia-Lymphoma, MESH: Humans, business.industry, MESH: Child, Preschool, Infant, MESH: Adult, medicine.disease, Survival Analysis, MESH: Male, Surgery, MESH: Recurrence, Transplantation, business, MESH: Female, 030215 immunology
Abstract

Purpose Patients with acute leukemia refractory to induction or reinduction chemotherapy have poor prognoses if they do not undergo hematopoietic stem-cell transplantation (HSCT). However, HSCT when a patient is not in complete remission (CR) is of uncertain benefit. We hypothesized that pretransplantation variables may define subgroups that have a better prognosis. Patients and Methods Overall, 2,255 patients who underwent transplantation for acute leukemia in relapse or with primary induction failure after myeloablative conditioning regimen between 1995 and 2004 were reported to the Center for International Blood and Marrow Transplant Research. The median follow-up of survivors was 61 months. We performed multivariate analysis of pretransplantation variables and developed a predictive scoring system for survival. Results The 3-year overall survival (OS) rates were 19% for acute myeloid leukemia (AML) and 16% for acute lymphoblastic leukemia (ALL). For AML, five adverse pretransplantation variables significantly influenced survival: first CR duration less than 6 months, circulating blasts, donor other than HLA-identical sibling, Karnofsky or Lansky score less than 90, and poor-risk cytogenetics. For ALL, survival was worse with the following: first refractory or second or greater relapse, ≥ 25% marrow blasts, cytomegalovirus-seropositive donor, and age of 10 years or older. Patients with AML who had a predictive score of 0 had 42% OS at 3 years, whereas OS was 6% for a score ≥ 3. Patients with ALL who had a score of 0 or 1 had 46% 3-year OS but only 10% OS rate for a score ≥ 3. Conclusion Pretransplantation variables delineate subgroups with different outcomes. HSCT during relapse can achieve long-term survival in selected patients with acute leukemia.

Published
2010
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13. High-dose therapy and autologous stem-cell transplantation in waldenstrom macroglobulinemia: the lymphoma working party of the european group for blood and marrow transplantation

Author

Noel Milpied, K Thomson, David Sibon, Norbert Schmitz, Paolo Corradini, Dietger Niederwieser, Karel Indrák, Carmen Canals, Jean-Yves Cahn, Norbert Claude Gorin, William Arcese, Karin Kolbe, Anna Sureda, Charalampia Kyriakou, Majid Kazmi, Service d'hématologie-oncologie adultes, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), TheREx, Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Haematology Stem Cell Transplant Unit, Tor Vergata University, Haematology, CHU Bordeaux [Bordeaux], Dept. of Haematology and Oncology, University Hospital, Department of Hemato-Oncology, University Hospital Olomouc [Czech Republic], Department of Haematology and Stem Cell Transplantation, Asklepios Klinik St. Georg Hamburg, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), and University Hospital Olomouc

Subjects
Oncology, Male, Cancer Research, Time Factors, Transplantation Conditioning, MESH: Registries, Kaplan-Meier Estimate, MESH: Risk Assessment, MESH: Proportional Hazards Models, 0302 clinical medicine, Autologous stem-cell transplantation, MESH: Risk Factors, Recurrence, Risk Factors, Antineoplastic Combined Chemotherapy Protocols, Cumulative incidence, Registries, Young adult, MESH: Transplantation Conditioning, MESH: Treatment Outcome, MESH: Aged, MESH: Middle Aged, MESH: Waldenstrom Macroglobulinemia, MESH: Immunologic Factors, Waldenstrom macroglobulinemia, Middle Aged, MESH: Transplantation, Autologous, 3. Good health, Europe, MESH: Antineoplastic Combined Chemotherapy Protocols, Treatment Outcome, MESH: Young Adult, 030220 oncology & carcinogenesis, Rituximab, Female, MESH: Stem Cell Transplantation, Waldenstrom Macroglobulinemia, MESH: Whole-Body Irradiation, Whole-Body Irradiation, medicine.drug, Adult, medicine.medical_specialty, [SDV.CAN]Life Sciences [q-bio]/Cancer, Risk Assessment, Transplantation, Autologous, Disease-Free Survival, 03 medical and health sciences, Young Adult, Internal medicine, medicine, Humans, Immunologic Factors, MESH: Patient Selection, MESH: Kaplan-Meier Estimate, Aged, Proportional Hazards Models, Retrospective Studies, MESH: Humans, business.industry, Patient Selection, MESH: Time Factors, Retrospective cohort study, MESH: Adult, MESH: Retrospective Studies, medicine.disease, MESH: Male, Surgery, MESH: Recurrence, Transplantation, MESH: Disease-Free Survival, Feasibility Studies, MESH: Europe, business, MESH: Feasibility Studies, MESH: Female, Settore MED/15 - Malattie del Sangue, 030215 immunology, Stem Cell Transplantation
Abstract

Purpose The role of autologous stem-cell transplantation (ASCT) in Waldenström macroglobulinemia (WM) is not defined. The aim of this study was to analyze the results of ASCT in patients with WM and to determine the prognostic factors that have a significant impact on outcome. Patients and Methods We analyzed 158 adult patients with WM reported to the European Group for Blood and Marrow Transplantation (EBMT) between January 1991 and December 2005. Median time from diagnosis to ASCT was 1.7 years (range, 0.3 to 20.3 years), 32% of the patients experienced treatment failure with at least three lines of therapy, and 93% had sensitive disease at the time of ASCT. Conditioning regimen was total-body irradiation–based in 45 patients. Median follow-up for surviving patients was 4.2 years (range, 0.5 to 14.8 years). Results Nonrelapse mortality was 3.8% at 1 year. Ten patients developed a secondary malignancy, with a cumulative incidence of 8.4% at 5 years. Relapse rate was 52.1% at 5 years. Progression-free survival (PFS) and overall survival were 39.7% and 68.5%, respectively, at 5 years and were significantly influenced by number of lines of therapy and chemorefractoriness at ASCT. The achievement of a negative immunofixation after ASCT had a positive impact on PFS after ASCT. When used as consolidation at first response, ASCT provided a PFS of 44% at 5 years. Conclusion ASCT is a feasible procedure in young patients with advanced WM. ASCT should not be offered to patients with chemoresistant disease and to those who received more than three lines of therapy.

Published
2010
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14. Immunomonitoring of graft-versus-host minor histocompatibility antigen correlates with graft-versus-host disease and absence of relapse after graft

Author

David Laurin, Martine Pernollet, Agnès Moine, Jean-Claude Bensa, Joel Plumas, Jean-Yves Cahn, Frédéric Garban, Dalil Hannani, Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Bases moléculaires de la progression tumorale -Groupe de Recherche sur les Lymphomes, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR73, Laboratoires Immunocytologie et HLA, département d'Immunologie Cellulaire, EFS, Hematology, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), TheREx, VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Département de cancérologie et d'hématologie, and CHU Grenoble-Hôpital Michallon-CHU Grenoble-Hôpital Michallon

Subjects
MESH: Minor Histocompatibility Antigens, Male, MESH: Tissue Donors, Transplantation Conditioning, medicine.medical_treatment, Graft vs Host Disease, Disease, Hematopoietic stem cell transplantation, MESH: Peripheral Blood Stem Cell Transplantation, MESH: T-Lymphocyte Subsets, CD8-Positive T-Lymphocytes, 0302 clinical medicine, immune system diseases, Recurrence, T-Lymphocyte Subsets, Minor histocompatibility antigen, Immunology and Allergy, MESH: Bone Marrow Transplantation, MESH: Transplantation Conditioning, Bone Marrow Transplantation, 0303 health sciences, MESH: Middle Aged, ELISPOT, MESH: Enzyme-Linked Immunosorbent Assay, [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology, Hematology, MESH: Transplantation, MESH: Follow-Up Studies, Middle Aged, MESH: CD8-Positive T-Lymphocytes, Tissue Donors, 3. Good health, Leukemia, surgical procedures, operative, MESH: Young Adult, Hematologic Neoplasms, Female, MESH: Immunosuppressive Agents, Immunosuppressive Agents, Adult, Adolescent, MESH: Interferon-gamma, Immunology, MESH: Graft vs Host Disease, Enzyme-Linked Immunosorbent Assay, Graft vs Leukemia Effect, Minor Histocompatibility Antigens, 03 medical and health sciences, Interferon-gamma, Young Adult, Antigen, medicine, MESH: Transplantation, Homologous, Humans, Transplantation, Homologous, 030304 developmental biology, MESH: Adolescent, Peripheral Blood Stem Cell Transplantation, Transplantation, MESH: Humans, business.industry, MESH: Adult, MESH: Graft vs Leukemia Effect, medicine.disease, MESH: Male, Histocompatibility, MESH: Recurrence, Graft-versus-host disease, Feasibility Studies, business, MESH: Feasibility Studies, MESH: Female, 030215 immunology, MESH: Hematologic Neoplasms, Follow-Up Studies
Abstract

International audience; BACKGROUND: After HLA-identical hematopoietic stem cell transplantation, minor histocompatibility (mH) antigen alloreactivity plays a dominant role in the development of graft-versus-host disease (GVHD) and graft versus leukemia (GVL). STUDY DESIGN AND METHODS: We have analyzed the mH alloreactivity (enzyme-linked immunospot [ELISpot] for interferon-gamma[IFN-gamma] assay) from 24 donor/recipient pairs over a period of 2 years of follow-up and correlated such alloreactivity with the development of GVHD or absence of relapse. Circulating specific T cells anti-mH with multimer HLA-peptides were also studied. RESULTS: We show by ELISpot IFN-gamma assay that alloreactivity during the first 3 months from donor versus recipient or donor versus mismatched identified mH antigens is associated with acute GVHD and GVL effect. In addition, we demonstrate that the donor-versus-recipient reactivity observed after the third month is highly associated with chronic GVHD and GVL (p = 0.0007). Finally, we show by multimer HLA-peptide assay that mH epitope-specific T cells present after 3 months are statistically related to the GVL effect. CONCLUSIONS: Our results provide a robust method to monitor mH antigen graft-versus-host reaction and suggest that current identified mH have predictive value on GVHD and GVL.

Published
2009
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15. Long-term follow-up results of IFM99-03 and IFM99-04 trials comparing nonmyeloablative allotransplantation with autologous transplantation in high-risk de novo multiple myeloma

Author

Moreau, Philippe, Garban, Frédéric, Attal, Michel, Michallet, Mauricette, Marit, Gérald, Hulin, Cyrille, Benboubker, Lotfi, Doyen, Chantal, Mohty, Mohamad, Yakoub-Agha, Ibrahim, Leyvraz, Serge, Casassus, Philippe, Avet-Loiseau, Hervé, Garderet, Laurent, Mathiot, Claire, Harousseau, Jean-Luc, Renseigné, Non, Hématologie et oncologie pédiatrique, Département de cancérologie et d'hématologie, CHU Grenoble-Hôpital Michallon, Laboratoire d'Hématologie [Purpan], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Service d'hématologie [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service des maladies du sang, CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux]-Groupe Hospitalier Sud, 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), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service d'hématologie clinique [Avicenne], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13)-Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'hématologie clinique, Hôpital Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Cochin (UMR_S567 / UMR 8104), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Toulouse III - Paul Sabatier ( UPS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Centre de Recherche en Cancérologie / Nantes - Angers ( CRCNA ), CHU Angers-Centre hospitalier universitaire de Nantes ( CHU Nantes ) -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 Régional Universitaire de Nancy ( CHRU Nancy ), Université Paris 13 ( UP13 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Avicenne, Institut Cochin ( UMR_S567 / UMR 8104 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Centre de Recherche en Cancérologie / Nantes - Angers (CRCNA), Centre hospitalier universitaire de Nantes (CHU Nantes)-Faculté de Médecine d'Angers-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Centre National de la Recherche Scientifique (CNRS)-Hôpital Laennec-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôtel-Dieu de Nantes, Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Avicenne, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)

Subjects
medicine.medical_specialty, MESH : Transplantation, Autologous, MESH : Transplantation, Homologous, Long term follow up, MESH : Transplantation Conditioning, medicine.medical_treatment, Immunology, MESH: Multiple Myeloma, [SDV.CAN]Life Sciences [q-bio]/Cancer, Biochemistry, MESH : Stem Cell Transplantation, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, Conditioning regimen, 03 medical and health sciences, 0302 clinical medicine, Autologous stem-cell transplantation, MESH: Risk Factors, hemic and lymphatic diseases, medicine, MESH: Transplantation, Homologous, Autologous transplantation, Multiple myeloma, ComputingMilieux_MISCELLANEOUS, MESH: Transplantation Conditioning, MESH: Humans, business.industry, MESH : Humans, MESH : Follow-Up Studies, Cell Biology, Hematology, MESH: Follow-Up Studies, medicine.disease, MESH : Risk Factors, MESH: Transplantation, Autologous, 3. Good health, Surgery, Fludarabine, 030220 oncology & carcinogenesis, MESH: Disease-Free Survival, MESH : Disease-Free Survival, MESH: Stem Cell Transplantation, MESH : Multiple Myeloma, business, Busulfan, 030215 immunology, medicine.drug, Allotransplantation
Abstract

To the editor: Recent pilot studies combining a cytoreductive autologous stem cell transplantation (ASCT) with a reduced-intensity conditioning regimen (RIC) allograft have reported encouraging results in patients with de novo multiple myeloma (MM).[1][1],[2][2] However, it remains to be determined

Published
2008
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16. Predictive factors for outcomes after reduced intensity conditioning hematopoietic stem cell transplantation for hematological malignancies: a 10-year retrospective analysis from the Société Française de Greffe de Moelle et de Thérapie Cellulaire

Author

Zina Chir, Noel Milpied, Mauricette Michallet, Marc Renaud, Jean-Michel Boiron, Bernard Rio, Ibrahim Yakoub-Agha, Eric Deconinck, Quoc-Hung Le, Didier Blaise, Franck E. Nicolini, Bruno Lioure, Michel Attal, Helene Esperou, Thomas Prebet, Jean-Henri Bourhis, Mohamad Mohty, Pierre Bordigoni, Service d'hématologie [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service d'hématologie clinique, Hôpital Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), Agence de la biomédecine [Saint-Denis la Plaine], Laboratoire d'Hématologie [Purpan], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Service des maladies du sang, CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux]-Groupe Hospitalier Sud, Service d'onco-hématologie, CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Département d'Hématologie et Oncologie Médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service greffe de moelle osseuse, Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Hôpital Haut-Lévêque, Université Sciences et Technologies - Bordeaux 1-CHU Bordeaux [Bordeaux], Service Hématologie - IUCT-Oncopole [CHU Toulouse], Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle IUCT [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Université Sciences et Technologies - Bordeaux 1 (UB)-CHU Bordeaux [Bordeaux], and Saas, Philippe

Subjects
Oncology, Male, MESH: Remission Induction, Cancer Research, Multivariate analysis, Transplantation Conditioning, MESH: Registries, MESH: Busulfan, medicine.medical_treatment, Graft vs Host Disease, Hematopoietic stem cell transplantation, 0302 clinical medicine, MESH: Antilymphocyte Serum, MESH: Risk Factors, Risk Factors, MESH: Child, Medicine, Registries, Child, MESH: Transplantation Conditioning, MESH: Treatment Outcome, MESH: Aged, MESH: Middle Aged, MESH: Time, Remission Induction, Hematopoietic Stem Cell Transplantation, MESH: Follow-Up Studies, Hematology, Total body irradiation, Middle Aged, MESH: Infant, MESH: Predictive Value of Tests, 3. Good health, Fludarabine, Treatment Outcome, MESH: Survival Analysis, 030220 oncology & carcinogenesis, Reduced Intensity Conditioning, Child, Preschool, Hematologic Neoplasms, MESH: Vidarabine, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, France, Vidarabine, medicine.drug, Adult, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, Adolescent, MESH: Graft vs Host Disease, MESH: Multivariate Analysis, Disease-Free Survival, Time, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, MESH: Transplantation, Homologous, Genetics, Humans, Transplantation, Homologous, Molecular Biology, Busulfan, MESH: Hematopoietic Stem Cell Transplantation, Aged, Antilymphocyte Serum, Retrospective Studies, MESH: Adolescent, MESH: Humans, business.industry, MESH: Child, Preschool, Infant, MESH: Adult, MESH: Retrospective Studies, Retrospective cohort study, Cell Biology, Survival Analysis, MESH: Male, Surgery, MESH: France, Transplantation, MESH: Disease-Free Survival, Multivariate Analysis, business, MESH: Female, MESH: Hematologic Neoplasms, 030215 immunology, Follow-Up Studies
Abstract

International audience; This retrospective study analyzed the impact of demographic and transplantation variables on outcomes of 1108 patients who have undergone allogeneic hematopoietic stem cell transplantation after reduced intensity conditioning (RIC HSCT) for hematological malignancies and were reported to the Société Française de Greffe de Moelle et de Thérapie Cellulaire registry between November 1994 and December 2004. Only 442 patients (40%) were in complete remission (CR) at time of transplantation. Peripheral blood stem cells were used in the majority of patients (n = 878; 79%), 255 patients received fludarabine and low-dose total body irradiation, while 465 patients (42%) fludarabine and busulfan with rabbit anti-thymocyte globulins (ATG). The impact of demographic and transplant variables was studied on overall (OS) and event-free survival (EFS) in univariate and multivariate analysis. With a median follow-up of 21 months, 3-year probability of OS and EFS was 42% and 30%, respectively, and treatment-related mortality was 15% at 2 years. The multivariate analysis showed a significant negative impact on OS and EFS of the absence of CR status before transplantation; conditioning regimen, including >10 mg/kg ATG; and minor ABO incompatibility. In conclusion, this study highlights the major impact on RIC HSCT outcome of disease status before transplantation, ATG dose and ABO incompatibility.

Published
2007
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17. Long-term outcomes after reduced-intensity conditioning allogeneic stem cell transplantation for low-grade lymphoma: a survey by the French Society of Bone Marrow Graft Transplantation and Cellular Therapy (SFGM-TC)

Author

Patrice Chevalier, Reza Tabrizi, Hervé Tilly, Bruno Lioure, Eric Deconinck, Gérard Socié, Jill-Patrice Cassuto, Lionel Ades, Didier Blaise, Mauricette Michallet, Mathieu Kuentz, Michel Attal, Pierre Bordigoni, Thierry Facon, Frédéric Garban, Jean-Paul Vernant, Stéphane Vigouroux, Noel Milpied, Marc Bernard, Norbert Ifrah, Jean-Henri Bourhis, Marc Renaud, Raphaël Porcher, Centre Hospitalier Universitaire [Rennes], Service d'hématologie [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service d'hématologie biologique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire d'Hématologie [Purpan], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Centre de Recherche en Cancérologie de Marseille (CRCM), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Aix Marseille Université (AMU), Hôpital Haut-Lévêque, Université Sciences et Technologies - Bordeaux 1-CHU Bordeaux [Bordeaux], Département de cancérologie et d'hématologie, CHU Grenoble-Hôpital Michallon, Laboratoire d'Immunologie, Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital l'Archet, Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Claude Huriez [Lille], CHU Lille, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Hôpital de la Milétrie, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Service d'Hématologie, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'hématologie clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Gustave Roussy (IGR), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service d'onco-hématologie, CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Saas, Philippe, Service Hématologie - IUCT-Oncopole [CHU Toulouse], Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle IUCT [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Sciences et Technologies - Bordeaux 1 (UB)-CHU Bordeaux [Bordeaux], and Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC)

Subjects
Male, Oncology, MESH: Remission Induction, Transplantation Conditioning, MESH: Busulfan, medicine.medical_treatment, Graft vs Host Disease, MESH: Antibodies, Monoclonal, 0302 clinical medicine, MESH: Antilymphocyte Serum, Antineoplastic Combined Chemotherapy Protocols, Melphalan, Etoposide, MESH: Etoposide, MESH: Transplantation Conditioning, MESH: Treatment Outcome, Hematology, MESH: Middle Aged, Remission Induction, Hematopoietic Stem Cell Transplantation, Antibodies, Monoclonal, Total body irradiation, 3. Good health, Survival Rate, MESH: Antineoplastic Combined Chemotherapy Protocols, 030220 oncology & carcinogenesis, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, Graft vs Leukemia Effect, RIC allogeneic transplantation, Disease-Free Survival, 03 medical and health sciences, MESH: Melphalan, Humans, Cyclophosphamide, Aged, Antilymphocyte Serum, Retrospective Studies, MESH: Humans, MESH: Cyclophosphamide, MESH: Adult, MESH: Retrospective Studies, Survival Analysis, Regimen, MESH: Disease-Free Survival, MESH: Female, Busulfan, MESH: Combined Modality Therapy, T-Lymphocytes, MESH: Carmustine, Kaplan-Meier Estimate, MESH: Proportional Hazards Models, MESH: Lymphoma, Non-Hodgkin, hemic and lymphatic diseases, MESH: Cytarabine, MESH: Data Collection, MESH: Kaplan-Meiers Estimate, MESH: Aged, Data Collection, Lymphoma, Non-Hodgkin, Cytarabine, Middle Aged, Combined Modality Therapy, Fludarabine, MESH: Salvage Therapy, Treatment Outcome, medicine.anatomical_structure, MESH: Survival Analysis, MESH: Vidarabine, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, France, MESH: Whole-Body Irradiation, Vidarabine, Whole-Body Irradiation, medicine.drug, Adult, MESH: Survival Rate, MESH: Graft vs Host Disease, Internal medicine, medicine, MESH: Transplantation, Homologous, Transplantation, Homologous, MESH: Hematopoietic Stem Cell Transplantation, Proportional Hazards Models, Salvage Therapy, Chemotherapy, business.industry, MESH: Graft vs Leukemia Effect, Carmustine, low-grade lymphoma, MESH: Male, Surgery, Transplantation, MESH: France, MESH: T-Lymphocytes, Bone marrow, business, 030215 immunology
Abstract

International audience; BACKGROUND AND OBJECTIVES: High-dose chemotherapy with allogeneic stem cell transplantation (SCT) has proven to be a successful treatment for low-grade lymphoma (LGL), but is associated with considerable transplant-related mortality (TRM). In an effort to reduce toxic mortality while maintaining the graft-versus-leukemia effect, allogeneic SCT has been combined with a reduced-intensity conditioning (RIC) regimen. The aim of this study was to determine the outcome of patients with LGL treated with RIC allogeneic SCT. DESIGN AND METHODS: This retrospective multicenter study included 73 patients with relapsed or refractory LGL allografted after a RIC regimen between 1998 and 2005 whose data were recorded in a French registry. RESULTS: Patients received a median of three lines of therapy prior to RIC allogeneic SCT. The most widely used conditioning regimens were fludarabine + busulfan + antithymocyte globulin (n=43) and fludarabine + total body irradiation (n=21). Prior to allografting, patients were in complete response (CR; n=21), partial response (PR; n=33) or had chemoresistant disease (n=19). The median follow-up was 37 months (range, 16 to 77 months). In patients in CR, PR and chemoresistant disease, the 3-year overall survival rates were 66%, 64% and 32%, respectively, while the 3-year event-free survival rates were 66%, 52% and 32%, respectively. The 3-year cumulative incidences of TRM were 32%, 28% and 63%, respectively. The incidence of relapse was 9.6%. INTERPRETATION AND CONCLUSIONS: Although associated with significant TRM, RIC allogeneic SCT in advanced chemosensitive disease leads to long-term survival.

Published
2007

18. Final height and gonad function after total body irradiation during childhood

Author

Christine Trivin, Jean Michon, Pierre Lemaire, André Baruchel, Helene Esperou, Ana-Claudia Couto-Silva, Raja Brauner, Université Paris Descartes - Paris 5 (UPD5), CHU Necker - Enfants Malades [AP-HP], Service greffe de moelle osseuse, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Conception synthèse et étude d'antitumoraux, Institut Curie-Centre National de la Recherche Scientifique (CNRS), Service d'hématologie pédiatrique, Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7), TIMB, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Institut Curie [Paris]-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Université Paris Descartes - Paris 5 ( UPD5 ), Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], INSTITUT CURIE-Centre National de la Recherche Scientifique ( CNRS ), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications [Grenoble] ( TIMC-IMAG ), and Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ) -Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA )

Subjects
Male, Transplantation Conditioning, MESH : Follicle Stimulating Hormone, Testicle, 0302 clinical medicine, MESH : Child, MESH: Child, Child, 10. No inequality, Growth Disorders, [ INFO.INFO-RO ] Computer Science [cs]/Operations Research [cs.RO], MESH: Transplantation Conditioning, Human Growth Hormone, Hematopoietic Stem Cell Transplantation, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Follow-Up Studies, Total body irradiation, MESH: Growth Disorders, Spermatozoa, MESH : Whole-Body Irradiation, Child, Preschool, Hematologic Neoplasms, 030220 oncology & carcinogenesis, MESH : Hematologic Neoplasms, medicine.medical_specialty, endocrine system, Ovary, Growth hormone deficiency, 03 medical and health sciences, MESH: Sex Factors, MESH : Adolescent, MESH : Hematopoietic Stem Cell Transplantation, MESH: Body Height, MESH : Spermatozoa, Humans, MESH : Ovary, MESH : Testis, MESH: Adolescent, MESH: Age Factors, MESH: Humans, MESH : Humans, MESH: Child, Preschool, MESH : Follow-Up Studies, MESH : Organ Size, MESH: Inhibins, medicine.disease, Endocrinology, Follicle Stimulating Hormone, MESH: Female, Hormone, MESH : Transplantation Conditioning, MESH: Organ Size, MESH : Child, Preschool, Testis, MESH: Follicle Stimulating Hormone, MESH: Human Growth Hormone, MESH : Female, MESH: Radiotherapy Dosage, MESH : Radiotherapy Dosage, MESH: Testis, MESH: Spermatozoa, Age Factors, Radiotherapy Dosage, Organ Size, Hematology, [INFO.INFO-RO]Computer Science [cs]/Operations Research [cs.RO], Growth hormone treatment, medicine.anatomical_structure, Female, medicine.symptom, MESH: Whole-Body Irradiation, Whole-Body Irradiation, MESH: Ovary, Gonad, Adolescent, MESH : Male, MESH : Sex Factors, MESH : Body Height, Short stature, Sex Factors, Internal medicine, medicine, MESH : Growth Disorders, Inhibins, MESH : Human Growth Hormone, MESH: Hematopoietic Stem Cell Transplantation, Transplantation, MESH : Inhibins, business.industry, Body Height, MESH: Male, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Age Factors, business, Follow-Up Studies, 030215 immunology, MESH: Hematologic Neoplasms
Abstract

International audience; Short stature and gonad failure can be a side effect of total body irradiation (TBI). The purpose of the study was to evaluate the factors influencing final height and gonad function after TBI. Fifty young adults given TBI during childhood were included. Twenty-seven had been treated with growth hormone (GH). Those given single 10 Grays (Gy) or fractionated 12 Gy TBI had similar characteristics, GH peaks, final heights and gonad function. After the end of GH treatment, 11/20 patients evaluated had GH peak >10 microg/l. Final height was

Published
2006
Full Text
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