6 results on '"Gardin, Claude"'
Search Results
2. Risk factors and decision criteria for intensive chemotherapy in older patients with acute myeloid leukemia
- Author
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Malfuson, Jean-Valère, Etienne, Anne, Turlure, Pascal, De Revel, Thierry, Thomas, Xavier, Contentin, Nathalie, Terré, Christine, Rigaudeau, Sophie, Bordessoule, Dominique, Vey, Norbert, Gardin, Claude, Dombret, Hervé, Renseigné, Non, Service d'Hématologie clinique et thérapie cellulaire [CHU Limoges], CHU Limoges, Génétique, immunothérapie, chimie et cancer (GICC), UMR 6239 CNRS [2008-2011] (GICC UMR 6239 CNRS), Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier de Versailles André Mignot (CHV), Service d'Hématologie biologique [CHU Limoges], Université de Limoges (UNILIM), Physiologie Moléculaire de la Réponse Immune et des Lymphoproliférations (PMRIL), Université de Limoges (UNILIM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Centre National de la Recherche Scientifique (CNRS), Lymphocyte et cancer, IFR105-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Tours-Centre National de la Recherche Scientifique (CNRS)
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Male ,MESH: Decision Making ,Multivariate analysis ,Leukocyte Count ,0302 clinical medicine ,MESH: Aged, 80 and over ,MESH: Practice Guidelines as Topic ,Risk Factors ,MESH: Risk Factors ,Epidemiology ,Aged, 80 and over ,MESH: Aged ,Clinical Trials as Topic ,Hematology ,Age Factors ,Myeloid leukemia ,Multiple-criteria decision analysis ,3. Good health ,Leukemia, Myeloid, Acute ,030220 oncology & carcinogenesis ,MESH: Survival Analysis ,Cytogenetic Analysis ,Practice Guidelines as Topic ,[SDV.IMM]Life Sciences [q-bio]/Immunology ,Female ,MESH: Leukemia, Myeloid, Acute ,MESH: Daunorubicin ,medicine.medical_specialty ,MESH: Clinical Trials as Topic ,Decision Making ,Antineoplastic Agents ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,MESH: Patient Selection ,Risk factor ,Intensive care medicine ,Aged ,MESH: Age Factors ,MESH: Humans ,business.industry ,Patient Selection ,MESH: Cytogenetic Analysis ,Daunorubicin ,MESH: Idarubicin ,Cancer ,medicine.disease ,Survival Analysis ,MESH: Male ,MESH: Leukocyte Count ,MESH: Antineoplastic Agents ,False positive rate ,business ,Idarubicin ,MESH: Female ,030215 immunology - Abstract
International audience; BACKGROUND: There is a need for standardization of treatment decisions in older patients with acute myeloid leukemia. The aim of the present study was to analyze the decisional value of poor risk factors in 416 elderly patients treated in the ALFA-9803 trial in order to derive a decisional index. DESIGN AND METHODS: Standard multivariate analysis was used to identify risk factors for overall survival. Risk factors were then considered as good decision tools if associated with a frequency >10% and a false positive rate or =75 years, performance status > or =2, and white cell count > or =50 x 10(9)/L. This simple two-class decisional index, which was validated in an independent patient set, enabled us to discriminate 100 patients (24%) who had an estimated overall survival of only 19% at 12 months, with a good 9% false positive rate. CONCLUSIONS: We propose waiting for cytogenetic information before making treatment decisions in elderly patients with acute myeloid leukemia. Those patients with unfavorable cytogenetics, as well as patients with at least two of the following features, age > or =75 years, performance status > or =2, and white cell count > or =50 x 10(9)/L, should not be considered for standard intensive chemotherapy (ClinicalTrials.gov identifier: NCT00363025).
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- 2008
3. An update of current treatments for adult acute myeloid leukemia.
- Author
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Dombret, Hervé and Gardin, Claude
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LEUKEMIA treatment , *MYELOID leukemia , *ACUTE promyelocytic leukemia , *HEMATOPOIETIC stem cell transplantation , *PURINES , *ARSENIC trioxide , *TRETINOIN - Abstract
Recent advances in acute myeloid leukemia (AML) biology and its genetic landscape should ultimately lead to more subsetspecific AML therapies, ideally tailored to each patient's disease. Although a growing number of distinct AML subsets have been increasingly characterized, patient management has remained disappointingly uniform. If one excludes acute promyelocytic leukemia, current AML management still relies largely on intensive chemotherapy and allogeneic hematopoietic stem cell transplantation (HSCT), at least in younger patients who can tolerate such intensive treatments. Nevertheless, progress has been made, notably in terms of standard drug dose intensification and safer allogeneic HSCT procedures, allowing a larger proportion of patients to achieve durable remission. In addition, improved identification of patients at relatively low risk of relapse should limit their undue exposure to the risks ofHSCTin first remission. The role of new effective agents, such as purine analogs or gemtuzumab ozogamicin, is still under investigation, whereas promising new targeted agents are under clinical development. In contrast, minimal advances have been made for patients unable to tolerate intensive treatment, mostly representing older patients. The availability of hypomethylating agents likely represents an encouraging first step for this latter population, and it is hoped will allow for more efficient combinations with novel agents. [ABSTRACT FROM AUTHOR]
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- 2016
- Full Text
- View/download PDF
4. Additional chromosomal abnormalities in patients with acute promyelocytic leukaemia (APL) do not confer poor prognosis: results of APL 93 trial.
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de Botton, Stéphane, Chevret, Sylvie, Sanz, Miguel, Dombret, Hervé, Thomas, Xavier, Guerci, Agnès, Fey, Martin, Rayon, Consuelo, Huguet, Françoise, Sotto, Jean-Jacques, Gardin, Claude, Cony Makhoul, Pascale, Travade, Philippe, Solary, Eric, Fegueux, Nathalie, Bordessoule, Dominique, San Miguel, Jesus, Link, Harmut, Desablens, Bernard, and Stamatoullas, Aspasia
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CHROMOSOME abnormalities ,LEUKEMIA ,DRUG therapy ,LEUCOCYTES ,MYELOID leukemia - Abstract
In spite of the recent improvement in the outcome of acute promyelocytic leukaemia (APL) with treatment combining all trans retinoic acid (ATRA) and chemotherapy (CT), some patients with this disease still have a poor outcome. The prognostic significance of chromosomal abnormalities in addition to t(15;17) in APL is uncertain. We examined the prognostic significance of secondary chromosomal changes in 292 patients included in a European trial who were treated with ATRA and CT. The incidence of chromosomal abnormalities in addition to t(15;17) was 26% and trisomy 8 was the most frequent secondary change (46% of the cases with secondary changes). No significant differences were seen with regard to age, sex, initial white blood cell count, % of circulating blasts, platelet count, fibrinogen level and incidence of microgranular variants between patients with or without additional rearrangements. Outcome was also similar between patients with t(15;17) alone and patients with t(15;17) and other clonal abnormalities for complete remission (92% vs. 93% respectively), event-free survival at 2 years (76·1% vs. 78·1% respectively), relapse at 2 years (16·7% vs. 11·6% respectively) and overall survival at 2 years (79·9% vs. 79·5% respectively). Analysis according to the type of induction treatment (ATRA followed by CT or ATRA plus CT) or the type of maintenance treatment (with ATRA, low-dose CT or both) also failed to show any difference between the two groups. Thus, in a large cohort of APL patients treated with ATRA and CT, additional chromosomal abnormalities had no impact on prognosis. [ABSTRACT FROM AUTHOR]
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- 2000
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5. Minimal residual disease monitoring based on FLT3 internal tandem duplication in adult acute myeloid leukemia
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Abdelhamid, Emna, Preudhomme, Claude, Helevaut, Nathalie, Nibourel, Olivier, Gardin, Claude, Rousselot, Philippe, Castaigne, Sylvie, Gruson, Bérengère, Berthon, Céline, Soua, Zohra, and Renneville, Aline
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MYELOID leukemia , *BIOMARKERS , *POLYMERASE chain reaction , *GENETIC mutation , *GENE expression , *POLYMERIZATION - Abstract
Abstract: FLT3 internal tandem duplication (FLT3-ITD) is usually considered as a bad marker for minimal residual disease (MRD) follow-up in acute myeloid leukemia (AML). Our objective was to evaluate the suitability of FLT3-ITD as a target for MRD detection by real-time quantitative PCR, in comparison with two other molecular MRD markers, NPM1 mutation and WT1 overexpression, in 20 adult AML patients treated in Acute Leukemia French Association (ALFA) trials. Overall, these 3 MRD markers showed comparable kinetics in 17/20 (85%) cases. Furthermore, we found that FLT3-ITD MRD levels after induction chemotherapy are predictive of complete remission duration. [Copyright &y& Elsevier]
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- 2012
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6. Erlotinib and gefitinib for the treatment of myelodysplastic syndrome and acute myeloid leukemia: A preclinical comparison
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Boehrer, Simone, Adès, Lionel, Galluzzi, Lorenzo, Tajeddine, Nicolas, Tailler, Maximilien, Gardin, Claude, de Botton, Stéphane, Fenaux, Pierre, and Kroemer, Guido
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CHEMICAL inhibitors , *EPIDERMAL growth factor , *MYELODYSPLASTIC syndromes treatment , *MYELOID leukemia , *LEUKEMIA treatment , *APOPTOSIS , *PROTEIN-tyrosine kinases , *CELL differentiation , *THERAPEUTICS - Abstract
Abstract: Erlotinib and gefitinib, two inhibitors of the epidermal growth factor receptor (EGFR), can stimulate apoptosis and differentiation of myeloid cell lines that lack EGFR, unveiling a novel, therapeutically exploitable off-target effect of tyrosine kinase inhibitors. Here, we performed a side-by-side comparison of erlotinib and gefitinib effects on a broad spectrum of malignant myeloid cell lines, as well as on primary myeloblasts freshly purified from the bone marrow of patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Both erlotinib and gefitinib induce apoptosis of a cell line (KG-1) that represents AML, and differentiation in another cell line (P39) derived from a patient with high-risk MDS. In this setting, erlotinib was more efficient than gefitinib. Erlotinib and gefitinib were equipotent in inducing apoptosis of primary CD34+ myeloblasts from MDS and AML patients, yet had no toxic effect on CD34+ progenitor cells from healthy donors. Although the response of individual MDS and AML patients in vitro was highly heterogeneous, the pro-apoptotic effects of erlotinib and gefitinib correlated significantly. These results suggest that erlotinib and gefitinib share a mechanistically related off-target effect that may be taken advantage of for the therapy of MDS and AML. [Copyright &y& Elsevier]
- Published
- 2008
- Full Text
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