285 results on '"Aspasia Stamatoullas"'
Search Results
2. Complete hematologic response after belinostat treatment and allogeneic stem cell transplantation for multiple relapsed/refractory angioimmunoblastic T‐cell lymphoma: A case report
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Vincent Camus, Pascaline Etancelin, Fanny Drieux, Elena‐Liana Veresezan, Jean‐Michel Picquenot, Dominique Penther, Mathieu Viennot, Philippe Ruminy, Nathalie Contentin, Emilie Lemasle, Stéphane Leprêtre, Sydney Dubois, Juliette Penichoux, Aspasia Stamatoullas, Alexandra Zduniak, Hélène Lanic, and Fabrice Jardin
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allogenic stem cell transplantation ,belinostat ,complete response ,HDAC inhibitor ,nTFHL‐AI ,PTCL ,Medicine ,Medicine (General) ,R5-920 - Abstract
Key Clinical Message This case report highlights the potential of belinostat for the treatment of relapsed/refractory peripheral T‐cell lymphomas, for which effective therapies are still scarce. Abstract Peripheral T‐cell lymphomas have an aggressive disease course associated with poor outcomes. We report a young patient with highly pretreated relapsed/refractory nodal follicular helper T‐cell lymphoma (angioimmunoblastic‐type [nTFHL‐AI]), who successfully received an allogeneic stem cell transplantation following belinostat therapy. The complete hematologic response achieved has lasted more than 2 years.
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- 2023
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3. Prognostic value of baseline metabolic tumour volume in advanced-stage Hodgkin’s lymphoma
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Pierre Pinochet, Edgar Texte, Aspasia Stamatoullas-Bastard, Pierre Vera, Sorina-Dana Mihailescu, and Stéphanie Becker
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Medicine ,Science - Abstract
Abstract Our aim was to evaluate the prognostic value of initial total metabolic tumour volume (TMTV) in a population of patients with advanced-stage Hodgkin’s lymphoma (HL). We retrospectively included 179 patients with stage IIb-III-IV Hodgkin’s disease who received BEACOPP or ABVD as the first-line treatment. The initial TMTV was determined using a semi-automatic method for each patient. We analysed its prognostic value in terms of 5-year progression-free survival (PFS), overall survival, and positron emission tomography (PET) response after two courses of chemotherapy. Considering all the treatments and using a threshold of 217 cm3, TMTV was predictive of 5-year PFS and PET response after two courses of chemotherapy. In multivariable analysis involving TMTV, IPI score, and the first treatment received, TMTV remained a baseline prognostic factor for 5-year PFS. In the subgroup of patients treated with BEACOPP with a threshold of 331 cm3, TMTV was predictive of PET response, but not 5-year PFS (p = 0.087). The combined analysis of TMTV and PET response enabled the individualisation of a subgroup of patients (low TMTV and complete response on PET) with a very low risk of recurrence. Baseline TMTV appears to be a useful independent prognostic factor for predicting relapse in advanced-stage HL in ABVD subgroup, with a tendency of survival curves separation in BEACOPP subgroup.
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- 2021
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4. Relapsed and refractory classical Hodgkin lymphoma: could virotherapy help solve the equation?
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Selma Addou, Clémentine Sarkozy, Julien Lazarovici, Stéphane Champiat, Aspasia Stamatoullas, Fabrice Jardin, Vincent Ribrag, Aurélien Marabelle, and Jean-Marie Michot
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hodgkin lymphoma ,virotherapy ,oncolytic viruses ,epstein-barr virus ,Immunologic diseases. Allergy ,RC581-607 ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Classical Hodgkin lymphoma is a neoplastic hematological disease. Standard first-line therapy, including chemotherapy and radiotherapy, is curative in >85% of early-stage patients, with a 5-year survival rate of >95%. However, approximately 15% of patients have hard-to-treat lymphoma with poor outcomes, and new treatment strategies are needed for these young adults. There are several well-documented cases in the medical literature on hematologic cancer remission following natural human viral infections. Therefore, hoping to reproduce these spontaneous tumor regressions, researchers have been investigating various viruses with oncolytic properties. There is a high rationale for using virotherapy in the treatment of Hodgkin lymphoma, in which tumor cells are often infected with the Epstein-Barr virus. Modern viral technologies and current knowledge about the relationship between viruses and cancer could accelerate the discovery of effective viral oncolytic therapies. This article reviews the use of oncolytic viruses as innovative therapies for treating Hodgkin lymphoma.
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- 2021
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5. Successful treatment of severe post hematopoietic stem cell transplantation bronchiolitis obliterans syndrome with lung transplantation in a patient with multi‐organ chronic graft‐versus‐host disease
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Juliette Pénichoux, Florian Bouclet, Mustafa Alani, Nathalie Contentin, Anne‐Lise Ménard, Stéphane Leprêtre, Pascal Lenain, Aspasia Stamatoullas, Elodie Lhuillier, Hélène Lanic, Emilie Lemasle, Sydney Dubois, Jean‐Henri Bourhis, Hervé Mal, Fabrice Jardin, and Vincent Camus
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allogeneic hematopoietic stem cell transplantation ,bronchiolitis obliterans syndrome ,graft‐versus‐host disease ,Medicine ,Medicine (General) ,R5-920 - Abstract
Abstract Allogeneic stem cell transplant and chronic graft‐versus‐host disease may lead to severe non‐infectious pulmonary disease in 6% of patients at 5 years. We report the case of a young patient with acute myeloid leukemia who successfully received bilateral lung transplantation for severe bronchiolitis obliterans syndrome.
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- 2022
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6. High-risk stage IIB Hodgkin lymphoma treated in the H10 and AHL2011 trials: total metabolic tumor volume is a useful risk factor to stratify patients at baseline
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Cédric Rossi, Marc André, Jehan Dupuis, Franck Morschhauser, Bertrand Joly, Julien Lazarovici, Hervé Ghesquières, Aspasia Stamatoullas, Emmanuelle Nicolas-Virelizier, Pierre Feugier, Anne-Claire Gac, Hannah Moatti, Luc-Matthieu Fornecker, Bénédicte Deau, Clémentine Joubert, Catherine Fortpied, John Raemaekers, Massimo Federico, Salim Kanoun, Michel Meignan, Alexandra Traverse-Glehen, Anne-Ségolène Cottereau, and René-Olivier Casasnova
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Stage IIB Hodgkin lymphoma (HL) patients, with a mediastinum-to-thorax (M/T) ratio of ≥0.33 or extranodal localization have a poor prognosis and are treated either as limited or advanced stage. We compared these two approaches in patients included in two randomized phase III trials enrolling previously untreated early (H10) or advanced stage HL (AHL2011). We included HL patients with Ann-Arbor stage IIB with M/T ≥0.33 or extranodal involvement enrolled in the H10 or AHL2011 trials with available positron emission tomography at baseline (PET0) and after two cycles of chemotherapy (PET2). Baseline total metabolic tumor volume (TMTV) was calculated using the 41% SUVmax method. PET2 response assessment used the Deauville score. One hundred and fourty-eight patients were eligible, including 83 enrolled in the AHL2011 trial and 65 in the H10 trial. The median TMTV value was 155.5 mL (range, 8.3-782.9 mL), 165.6 mL in AHL2011 and 147 mL in H10. PET2 positivity rates were 16.9% (n=14) and 9.2% (n=6) in AHL2011 and H10 patients, respectively. With a median follow-up of 4.1 years (95% confidence interval [CI]: 3.9-4.4), overall 4-year PFS was 88.0%, 87.0% in AHL2011 and 89.2% in H10. In univariate and mutivariate analyses, baseline TMTV and PET2 response influenced significantly progression-free survival (hazard ratio [HR]=4.94, HR=3.49 respectively). Notably, among the 16 patients who relapsed, 13 (81%) had a baseline TMTV baseline ≥155 mL. Upfront ABVD plus radiation therapy or upfront escBEACOPP without radiotherapy provide similar patient’s outcome in high-risk stage IIB HL. TMTV is useful to stratify these patients at baseline.
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- 2022
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7. Multiple cutaneous ulcers revealing a primary cutaneous Epstein‐Barr virus‐positive diffuse large B‐cell lymphoma
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Billal Tedbirt, Sydney Dubois, Lucie Cellier, Priscille Carvalho, Aspasia Stamatoullas, Philippe Courville, Aurélie Deschamps‐Huvier, Pascaline Etancelin, Anne Deniel, Hervé Tilly, Fabrice Jardin, Pascal Joly, and Vincent Camus
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cutaneous lymphoma ,cutaneous ulcers ,Epstein‐Barr virus ,Medicine ,Medicine (General) ,R5-920 - Abstract
Abstract Primary cutaneous EBV‐positive diffuse large B‐cell lymphoma is an exceptional and aggressive neoplasia with a poorer prognosis than other cutaneous lymphoma. Our observation points out the rarity of the presentation and the dismal clinical course.
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- 2020
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8. Outcomes of refractory or relapsed Hodgkin lymphoma patients with post-autologous stem cell transplantation brentuximab vedotin maintenance: a French multicenter observational cohort study
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Amira Marouf, Anne Segolene Cottereau, Salim Kanoun, Paul Deschamps, Michel Meignan, Patricia Franchi, David Sibon, Clara Antoine, Thomas Gastinne, Cecile Borel, Mohammad Hammoud, Guillaume Sicard, Romane Gille, Doriane Cavalieri, Aspasia Stamatoullas, Lauriane Filliatre-Clement, Julien Lazarovici, Adrien Chauchet, Luc-Matthieu Fornecker, Sandy Amorin, Mathieu Rocquet, Nicole Raus, Barbara Burroni, Marie Therese Rubio, Didier Bouscary, Philippe Quittet, Rene Olivier Casasnovas, Pauline Brice, Herve Ghesquieres, Jérôme Tamburini, and Benedicte Deau
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2021
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9. Dissociated humoral and cellular immune responses after a three-dose schema of BNT162b2 vaccine in patients receiving anti-CD20 monoclonal antibody maintenance treatment for B-cell lymphomas
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Sophie Candon, Veronique Lemee, Emilie Leveque, Pascaline Etancelin, Cedric Paquin, Marion Carette, Nathalie Contentin, Victor Bobee, Mustafa Alani, Nathalie Cardinael, Stephane Lepretre, Vincent Camus, Florian Bouclet, Edwige Boulet, Anne-Lise Menard, Helene Lanic, Aspasia Stamatoullas, Emilie Lemasle, Louis-Ferdinand Pepin, Doriane Richard, Sydney Dubois, Herve Tilly, Alain Dalleac, Jean-Christophe Plantier, Manuel Etienne, and Fabrice Jardin
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2021
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10. Fatigue level changes with time in long-term Hodgkin and non-Hodgkin lymphoma survivors: a joint EORTC-LYSA cross-sectional study
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Raphaël Busson, Marleen van der Kaaij, Nicolas Mounier, Berthe M. P. Aleman, Catherine Thiéblemont, Aspasia Stamatoullas, Vincent Ribrag, Hervé Tilly, Corinne Haioun, René-Olivier Casasnovas, Hanneke C. Kluin-Nelemans, and Michel Henry-Amar
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Hodgkin lymphoma ,Non-Hodgkin lymphomas ,Long-term survivors ,Fatigue ,Cross-sectional study ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background Long-term lymphoma survivors often complain of persistent fatigue that remains unexplained. While largely reported in Hodgkin lymphoma (HL), long-term fatigue is poorly documented in non-Hodgkin lymphomas (NHL). Data collected in two cohort studies were used to illustrate the fatigue level changes with time in the two populations. Methods Two cross-sectional studies were conducted in 2009–2010 (HL) and in 2015 (NHL) in survivors enrolled in European Organisation for Research and Treatment of Cancer (EORTC) Lymphoma Group and Lymphoma Study Association (LYSA) trials. The same protocol and questionnaires were used in both studies including the Multidimensional Fatigue Inventory (MFI) tool to assess fatigue and a checklist of health disorders. Multivariate linear regression models were used in the two populations separately to assess the influence of time since diagnosis and primary treatment, age, gender, education level, cohabitation status, obesity and health disorders on fatigue level changes. Fatigue level changes were compared to general population data. Results Overall, data of 2023 HL and 1619 NHL survivors with fatigue assessment available (99 and 97% of cases, respectively) were analyzed. Crude levels of fatigue were similar in the two populations. Individuals who reported health disorders (61% of HL and 64% of NHL) displayed higher levels of fatigue than those who did not (P
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- 2019
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11. Targeted genotyping of circulating tumor DNA for classical Hodgkin lymphoma monitoring: a prospective study
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Vincent Camus, Mathieu Viennot, Justine Lequesne, Pierre-Julien Viailly, Elodie Bohers, Lucile Bessi, Bénédicte Marcq, Pascaline Etancelin, Sydney Dubois, Jean-Michel Picquenot, Elena-Liana Veresezan, Marie Cornic, Lucie Burel, Justine Loret, Stéphanie Becker, Pierre Decazes, Pascal Lenain, Stéphane Lepretre, Emilie Lemasle, Hélène Lanic, Anne-Lise Ménard, Nathalie Contentin, Hervé Tilly, Aspasia Stamatoullas, and Fabrice Jardin
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
The relevance of circulating tumor DNA (ctDNA) analysis as a liquid biopsy and minimal residual disease tool in the management of classical Hodgkin Lymphoma (cHL) patients was demonstrated in retrospective settings and remains to be confirmed in a prospective setting. We developed a targeted Next-Generation sequencing (NGS) panel for fast analysis (AmpliSeq technology) of nine commonly mutated genes in biopies and ctDNA of cHL patients. We then conducted a prospective trial to assess ctDNA follow up at diagnosis and after 2 cycles of chemotherapy (C2). Sixty cHL patients treated by first line conventional chemotherapy (BEACOPPescalated [21.3%], ABVD/ABVD-like [73.5%] and other regimens [5.2%, for elderly patients] were assessed in this non-interventional study. Median age of the patients was 33.5 years (range 20-86). Variants were identified in 42 (70%) patients. Mutations of NFKBIE, TNFAIP3, STAT6, PTPN1, B2M, XPO1, ITPKB, GNA13 and SOCS1 were found in 13.3%, 31.7%, 23.3%, 5%, 33.3%, 10%, 23.3%, 13.3% and 50% of patients, respectively. ctDNA concentration and genotype are correlated with clinical characteristics and presentation. Regarding early therapeutic response, 45 patients (83%, NA=6) had a negative positron emission tomography (PET) after C2 (Deauville Score 1-3). Mean of DeltaSUVmax after C2 was -78.8%. We analyzed ctDNA after C2 for 54 patients (90%). ctDNA became rapidly undetectable in all cases after C2. Variant detection in ctDNA is suitable to depict the genetic features of cHL at diagnosis and may help to assess early treatment response, in association with PET. Clinical Trial reference: NCT02815137.
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- 2020
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12. A phase II study of guadecitabine in higher-risk myelodysplastic syndrome and low blast count acute myeloid leukemia after azacitidine failure
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Marie Sébert, Aline Renneville, Cécile Bally, Pierre Peterlin, Odile Beyne-Rauzy, Laurence Legros, Marie-Pierre Gourin, Laurence Sanhes, Eric Wattel, Emmanuel Gyan, Sophie Park, Aspasia Stamatoullas, Anne Banos, Kamel Laribi, Simone Jueliger, Luke Bevan, Fatiha Chermat, Rosa Sapena, Olivier Nibourel, Cendrine Chaffaut, Sylvie Chevret, Claude Preudhomme, Lionel Adès, and Pierre Fenaux
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
High-risk myelodysplastic syndrome/acute myeloid leukemia patients have a very poor survival after azacitidine failure. Guadecitabine (SGI-110) is a novel subcutaneous hypomethylating agent which results in extended decitabine exposure. This multicenter phase II study evaluated the efficacy and safety of guadecitabine in high-risk myelodysplastic syndrome and low blast count acute myeloid leukemia patients refractory or relapsing after azacitidine. We included 56 patients with a median age of 75 years [Interquartile Range (IQR) 69-76]. Fifty-five patients received at least one cycle of guadecitabine (60 mg/m2/d subcutaneously days 1-5 per 28-day treatment cycles), with a median of 3 cycles (range, 0-27). Eight (14.3%) patients responded, including two complete responses; median response duration was 11.5 months. Having no or few identified somatic mutations was the only factor predicting response (P=0.035). None of the 11 patients with TP53 mutation responded. Median overall survival was 7.1 months, and 17.9 months in responders (3 of whom had overall survival >2 years). In multivariate analysis, IPSS-R (revised International Prognostic Scoring System) score other than very high (P=0.03) primary versus secondary azacitidine failure (P=0.01) and a high rate of demethylation in blood during the first cycle of treatment (P=0.03) were associated with longer survival. Thus, guadecitabine can be effective, sometimes yielding relatively prolonged survival, in a small proportion of high-risk myelodysplastic syndrome/low blast count acute myeloid leukemia patients who failed azacitidine. (Trial registered at clinicaltrials.gov identifier: 02197676)
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- 2019
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13. A phase II study of the oral JAK1/JAK2 inhibitor ruxolitinib in advanced relapsed/refractory Hodgkin lymphoma
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Eric Van Den Neste, Marc André, Thomas Gastinne, Aspasia Stamatoullas, Corinne Haioun, Amine Belhabri, Oumedaly Reman, Olivier Casasnovas, Hervé Ghesquieres, Gregor Verhoef, Marie-José Claessen, Hélène A. Poirel, Marie-Christine Copin, Romain Dubois, Peter Vandenberghe, Ioanna-Andrea Stoian, Anne S. Cottereau, Sarah Bailly, Laurent Knoops, and Franck Morschhauser
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
JAK2 constitutive activation/overexpression is common in classical Hodgkin lymphoma, and several cytokines stimulate Hodgkin lymphoma cells by recognizing JAK1-/JAK2-bound receptors. JAK blockade may thus be therapeutically beneficial in Hodgkin lymphoma. In this phase II study we assessed the safety and efficacy of ruxolitinib, an oral JAK1/2 inhibitor, in patients with relapsed/refractory Hodgkin lymphoma. The primary objective was overall response rate according to the International Harmonization Project 2007 criteria. Thirty-three patients with advanced disease (median number of prior lines of treatment: 5; refractory: 82%) were included; nine (27.3%) received at least six cycles of ruxolitinib and six (18.2%) received more than six cycles. The overall response rate after six cycles was 9.4% (3/32 patients). All three responders had partial responses; another 11 patients had transient stable disease. Best overall response rate was 18.8% (6/32 patients). Rapid alleviation of B-symptoms was common. The median duration of response was 7.7 months, median progression-free survival 3.5 months (95% CI: 1.9–4.6), and the median overall survival 27.1 months (95% CI: 14.4–27.1). Forty adverse events were reported in 14/33 patients (42.4%). One event led to treatment discontinuation, while 87.5% of patients recovered without sequelae. Twenty-five adverse events were grade 3 or higher. These events were mostly anemia (n=11), all considered related to ruxolitinib. Other main causes of grade 3 or higher adverse events included lymphopenia and infections. Of note, no cases of grade 4 neutropenia or thrombocytopenia were observed. Ruxolitinib shows signs of activity, albeit short-lived, beyond a simple anti-inflammatory effect. Its limited toxicity suggests that it has the potential to be combined with other therapeutic modalities. ClinicalTrials.gov: NCT01877005
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- 2018
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14. Lenalidomide combined with intensive chemotherapy in acute myeloid leukemia and higher-risk myelodysplastic syndrome with 5q deletion. Results of a phase II study by the Groupe Francophone Des Myélodysplasies
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Lionel Ades, Thomas Prebet, Aspasia Stamatoullas, Christian Recher, Romain Guieze, Emmanuel Raffoux, Krimo Bouabdallah, Mathilde Hunault, Eric Wattel, Laure Stalnikiewicz, Andrea Toma, Hervé Dombret, Norbert Vey, Marie Sebert, Claude Gardin, Cendrine Chaffaut, Sylvie Chevret, and Pierre Fenaux
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Patients with acute myeloblastic leukemia or higher risk myelodysplastic syndromes with 5q deletion (generally within a complex karyotype) respond poorly to intensive chemotherapy and have very poor survival. In this population, we evaluated escalating doses of lenalidomide combined with intensive chemotherapy in a phase II study. Treatment consisted of daunorubicin (45 mg/m2/day, days 1–3 in cohort 1, escalated to 60 mg/m2/day, days 1–3 in cohorts 2 and 3) combined with cytosine arabinoside (200 mg/m2/day, days 1–7) and lenalidomide (10 mg/day, days 1–21 in cohorts 1 and 2, escalated to 25 mg/day, days 1–21 in cohort 3). Eighty-two patients with 5q deletion were enrolled, including 62 with acute myeloblastic leukemia, 62/79 (78%) of whom had a complex karyotype (median 7 cytogenetic abnormalities, all but 2 of them monosomal) and three had unknown karyotypes. Thirty-eight patients (46%) achieved complete remission and the overall response rate was 58.5%. Among the 62 patients with a complex karyotype, 27 achieved complete remission (44%) and 21 had cytogenetic responses. A lower response rate was observed in patients with acute myeloblastic leukemia but other pretreatment factors, including cytogenetic complexity and treatment cohort, did not significantly influence response. Fifteen patients underwent allogeneic stem cell transplantation, including 11 patients in first remission. The 1-year cumulative incidence of relapse was 64.6% and the median overall survival was 8.2 months. By comparison with conventional intensive chemotherapy, the treatment protocol we used appeared to produce higher hematologic and cytogenetic complete remission rates in patients with very poor cytogenetics, but response duration was short in this very poor risk population, highlighting the need for better post-induction strategies. Clinical trial registry number: NCT00885508
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- 2017
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15. Mediastinal gray zone lymphoma: clinico-pathological characteristics and outcomes of 99 patients from the Lymphoma Study Association
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Clémentine Sarkozy, Thierry Molina, Hervé Ghesquières, Anne-Sophie Michallet, Jehan Dupuis, Diane Damotte, Franck Morsschauser, Marie Parrens, Laurent Martin, Peggy Dartigues, Aspasia Stamatoullas, Pierre Hirsch, Bettina Fabiani, Krimo Bouabdallah, Maria Gomes da Silva, Marie Maerevoet, Camille Laurent, Bertrand Coiffier, Gilles Salles, and Alexandra Traverse-Glehen
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Mediastinal gray zone lymphoma, B-cell lymphomas with intermediate features between classical Hodgkin lymphoma and primary mediastinal B-cell lymphoma, have not been well described in the literature. We report the clinical characteristics and outcomes of a large retrospective series of 99 cases centrally reviewed by a panel of hematopathologists, with a consensus established for the diagnosis. Cases were defined as classical Hodgkin lymphoma-like morphology (64.6%) with primary mediastinal B-cell lymphoma immunophenotype, primary mediastinal B-cell lymphoma-like morphology (30.3%) with classical Hodgkin lymphoma or composite (5.1%) (synchronous occurrence of classical Hodgkin lymphoma and primary mediastinal B-cell lymphoma). The median age was 32 years (13–83 years); 55% were women. Thirteen of 81 evaluable cases (16%) were Epstein-Barr virus-positive. Twenty-eight percent of patients presented primary refractory disease (progression under first-line treatment or relapse within one year). The 3-year event-free and overall survival rates were 63% and 80%, respectively. Patients treated with a standard regimen (RCHOP/ABVD) had worse event-free survival (P=0.003) and overall survival (P=0.02) than those treated with a dose-intensive chemotherapy (high-dose RCHOP/escalated BEACOPP). Rituximab added to chemotherapy was not associated with better event-free survival (P=0.55) or overall survival (P=0.88). Radiotherapy for patients in complete remission had no impact on event-free survival. In multivariate prognostic analysis, ECOG-PS and anemia were the strongest factors associated with a shorter event-free survival and overall survival, respectively. In conclusion, this report describes the largest series of mediastinal gray zone lymphoma. Our data suggest that a dose-intensive treatment might improve the outcome of this rare and aggressive disease.
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- 2017
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16. Cardiac iron overload in chronically transfused patients with thalassemia, sickle cell anemia, or myelodysplastic syndrome.
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Mariane de Montalembert, Jean-Antoine Ribeil, Valentine Brousse, Agnes Guerci-Bresler, Aspasia Stamatoullas, Jean-Pierre Vannier, Cécile Dumesnil, Agnès Lahary, Mohamed Touati, Krimo Bouabdallah, Marina Cavazzana, Emmanuelle Chauzit, Amandine Baptiste, Thibaud Lefebvre, Hervé Puy, Caroline Elie, Zoubida Karim, Olivier Ernst, and Christian Rose
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Medicine ,Science - Abstract
The risk and clinical significance of cardiac iron overload due to chronic transfusion varies with the underlying disease. Cardiac iron overload shortens the life expectancy of patients with thalassemia, whereas its effect is unclear in those with myelodysplastic syndromes (MDS). In patients with sickle cell anemia (SCA), iron does not seem to deposit quickly in the heart. Our primary objective was to assess through a multicentric study the prevalence of cardiac iron overload, defined as a cardiovascular magnetic resonance T2*8 ECs in the past year, and age older than 6 years. We included from 9 centers 20 patients with thalassemia, 41 with SCA, and 25 with MDS in 2012-2014. Erythrocytapharesis did not consistently prevent iron overload in patients with SCA. Cardiac iron overload was found in 3 (15%) patients with thalassemia, none with SCA, and 4 (16%) with MDS. The liver iron content (LIC) ranged from 10.4 to 15.2 mg/g dry weight, with no significant differences across groups (P = 0.29). Abnormal T2* was not significantly associated with any of the measures of transfusion or chelation. Ferritin levels showed a strong association with LIC. Non-transferrin-bound iron was high in the thalassemia and MDS groups but low in the SCA group (P
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- 2017
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17. Detection and prognostic value of recurrent exportin 1 mutations in tumor and cell-free circulating DNA of patients with classical Hodgkin lymphoma
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Vincent Camus, Aspasia Stamatoullas, Sylvain Mareschal, Pierre-Julien Viailly, Nasrin Sarafan-Vasseur, Elodie Bohers, Sydney Dubois, Jean Michel Picquenot, Philippe Ruminy, Catherine Maingonnat, Philippe Bertrand, Marie Cornic, Valérie Tallon-Simon, Stéphanie Becker, Liana Veresezan, Thierry Frebourg, Pierre Vera, Christian Bastard, Hervé Tilly, and Fabrice Jardin
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Classical Hodgkin lymphoma is one of the most common lymphomas and shares clinical and genetic features with primary mediastinal B-cell lymphoma. In this retrospective study, we analyzed the recurrent hotspot mutation of the exportin 1 (XPO1, p.E571K) gene, previously identified in primary mediastinal B-cell lymphoma, in biopsies and plasma circulating cell-free DNA from patients with classical Hodgkin lymphoma using a highly sensitive digital PCR technique. A total of 94 patients were included in the present study. This widely expressed XPO1 E571K mutation is present in one quarter of classical Hodgkin lymphoma patients (24.2%). Mutated and wild-type classical Hodgkin lymphomas were similar regarding the main clinical features. Patients with a detectable XPO1 mutation at the end of treatment displayed a tendency toward shorter progression-free survival, as compared to patients with undetectable mutation in plasma cell-free DNA (2-year progression-free survival: 57.1%, 95% confidence interval: 30.1–100% versus 2-year progression-free survival: 90.5%, 95% confidence interval: 78.8–100%, respectively, P=0.0601). To conclude, the detection of the XPO1 E571K mutation in biopsy and plasma cell-free DNA by digital PCR may be used as a novel biomarker in classical Hodgkin lymphoma for both diagnosis and minimal residual disease, and pinpoints a crucial role of XPO1 in classical Hodgkin lymphoma pathogenesis. The detection of somatic mutation in the plasma cell-free DNA of patients represents a major technological advance in the context of liquid biopsies and noninvasive management of classical Hodgkin lymphoma.
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- 2016
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18. A randomized phase II trial of azacitidine +/− epoetin-β in lower-risk myelodysplastic syndromes resistant to erythropoietic stimulating agents
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Sylvain Thépot, Raouf Ben Abdelali, Sylvie Chevret, Aline Renneville, Odile Beyne-Rauzy, Thomas Prébet, Sophie Park, Aspasia Stamatoullas, Agnes Guerci-Bresler, Stéphane Cheze, Gérard Tertian, Bachra Choufi, Laurence Legros, Jean Noel Bastié, Jacques Delaunay, Marie Pierre Chaury, Laurence Sanhes, Eric Wattel, Francois Dreyfus, Norbert Vey, Fatiha Chermat, Claude Preudhomme, Pierre Fenaux, and Claude Gardin
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
The efficacy of azacitidine in patients with anemia and with lower-risk myelodysplastic syndromes, if relapsing after or resistant to erythropoietic stimulating agents, and the benefit of combining these agents to azacitidine in this setting are not well known. We prospectively compared the outcomes of patients, all of them having the characteristics of this subset of lower-risk myelodysplastic syndrome, if randomly treated with azacitidine alone or azacitidine combined with epoetin-β. High-resolution cytogenetics and gene mutation analysis were performed at entry. The primary study endpoint was the achievement of red blood cell transfusion independence after six cycles. Ninety-eight patients were randomised (49 in each arm). Median age was 72 years. In an intention to treat analysis, transfusion independence was obtained after 6 cycles in 16.3% versus 14.3% of patients in the azacitidine and azacitidine plus epoetin-β arms, respectively (P=1.00). Overall erythroid response rate (minor and major responses according to IWG 2000 criteria) was 34.7% vs. 24.5% in the azacitidine and azacitidine plus epoetin-β arms, respectively (P=0.38). Mutations of the SF3B1 gene were the only ones associated with a significant erythroid response, 29/59 (49%) versus 6/27 (22%) in SF3B1 mutated and unmutated patients, respectively, P=0.02. Detection of at least one “epigenetic mutation” and of an abnormal single nucleotide polymorphism array profile were the only factors associated with significantly poorer overall survival by multivariate analysis. The transfusion independence rate observed with azacitidine in this lower-risk population, but resistant to erythropoietic stimulating agents, was lower than expected, with no observed benefit of added epoetin, (clinicaltrials.gov identifier: 01015352).
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- 2016
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19. Impact of post-brentuximab vedotin consolidation on relapsed/refractory CD30+ Hodgkin lymphomas: a large retrospective study on 240 patients enrolled in the French Named-Patient Program
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Aurore Perrot, Hélène Monjanel, Réda Bouabdallah, Philippe Quittet, Clémentine Sarkozy, Marc Bernard, Aspasia Stamatoullas, Cécile Borel, Krimo Bouabdallah, Emmanuelle Nicolas-Virelizier, Marion Fournier, Franck Morschhauser, and Pauline Brice
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Brentuximab vedotin was reported to be effective and safe against refractory/relapsed Hodgkin lymphoma in cohorts of between 12 to 102 patients. Herein we report our retrospective analysis of the French experience with brentuximab vedotin used alone to treat 240 refractory/relapsed Hodgkin lymphoma patients enrolled in a named patient program between 2011 and 2013. All patients had histologically documented CD30+ Hodgkin lymphoma; 74% had refractory disease or early relapses. After a median of 3 lines of chemotherapy, brentuximab vedotin was infused intravenously (1.8 mg/kg every 3 weeks). The primary endpoint was best response. Response at the end of treatment, its duration, survival data and toxicity profile were secondary endpoints. Patients received a median of 6 cycles; 68 underwent a consolidation thereafter. The best response was observed after a median of 4 cycles in 145 (60.4%) patients: 33.8% complete response/unconfirmed complete response, 26.7% partial response. Objective responses were observed as decreased (39.3%) in the 28 patients >60 years. The median response duration was 8.4 months. With median follow-up at 16.1 months, median progression-free survival was 6.8 months and this was significantly longer for patients transplanted after brentuximab vedotin (a median of 18,8 months); median overall survival was not reached. No death has been linked to brentuximab vedotin toxicity. The most common adverse events were peripheral sensory neuropathy (29.3%) and hematological toxicity. The results of this analysis support the previously reported brentuximab vedotin efficacy with manageable toxicity. Because of the short-term responses in most patients, a high-dose therapy with stem cell transplantation for responders should be considered as quickly as possible.
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- 2016
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20. Nodular lymphocyte predominant Hodgkin lymphoma: a Lymphoma Study Association retrospective study
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Julien Lazarovici, Peggy Dartigues, Pauline Brice, Lucie Obéric, Isabelle Gaillard, Mathilde Hunault-Berger, Florence Broussais-Guillaumot, Emmanuel Gyan, Serge Bologna, Emmanuelle Nicolas-Virelizier, Mohamed Touati, Olivier Casasnovas, Richard Delarue, Frédérique Orsini-Piocelle, Aspasia Stamatoullas, Jean Gabarre, Luc-Matthieu Fornecker, Thomas Gastinne, Fréderic Peyrade, Virginie Roland, Emmanuel Bachy, Marc André, Nicolas Mounier, and Christophe Fermé
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Nodular lymphocyte predominant Hodgkin lymphoma represents a distinct entity from classical Hodgkin lymphoma. We conducted a retrospective study to investigate the management of patients with nodular lymphocyte predominant Hodgkin lymphoma. Clinical characteristics, treatment and outcome of adult patients with nodular lymphocyte predominant Hodgkin lymphoma were collected in Lymphoma Study Association centers. Progression-free survival (PFS) and overall survival (OS) were analyzed, and the competing risks formulation of a Cox regression model was used to control the effect of risk factors on relapse or death as competing events. Among 314 evaluable patients, 82.5% had early stage nodular lymphocyte predominant Hodgkin lymphoma. Initial management consisted in watchful waiting (36.3%), radiotherapy (20.1%), rituximab (8.9%), chemotherapy or immuno-chemotherapy (21.7%), combined modality treatment (12.7%), or radiotherapy plus rituximab (0.3%). With a median follow-up of 55.8 months, the 10-year PFS and OS estimates were 44.2% and 94.9%, respectively. The 4-year PFS estimates were 79.6% after radiotherapy, 77.0% after rituximab alone, 78.8% after chemotherapy or immuno-chemotherapy, and 93.9% after combined modality treatment. For the whole population, early treatment with chemotherapy or radiotherapy, but not rituximab alone (Hazard ratio 0.695 [0.320–1.512], P=0.3593) significantly reduced the risk of progression compared to watchful waiting (HR 0.388 [0.234–0.643], P=0.0002). Early treatment appears more beneficial compared to watchful waiting in terms of progression-free survival, but has no impact on overall survival. Radiotherapy in selected early stage nodular lymphocyte predominant Hodgkin lymphoma, and combined modality treatment, chemotherapy or immuno-chemotherapy for other patients, are the main options to treat adult patients with a curative intent.
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- 2015
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21. Classical Hodgkin’s lymphoma: the Lymphoma Study Association guidelines for relapsed and refractory adult patients eligible for transplant
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Eric Van Den Neste, Olivier Casasnovas, Marc André, Mohamed Touati, Delphine Senecal, Véronique Edeline, Aspasia Stamatoullas, Luc Fornecker, Bénédicte Deau, Thomas Gastinne, Oumédaly Reman, Isabelle Gaillard, Cécile Borel, Pauline Brice, and Christophe Fermé
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
The Hodgkin’s Lymphoma Committee of the Lymphoma Study Association (LYSA) gathered in 2012 to prepare guidelines on the management of transplant-eligible patients with relapsing or refractory Hodgkin’s lymphoma. The working group is made up of a multidisciplinary panel of experts with a significant background in Hodgkin’s lymphoma. Each member of the panel of experts provided an interpretation of the evidence and a systematic approach to obtain consensus was used. Grades of recommendation were not required since levels of evidence are mainly based on phase II trials or standard practice. Data arising from randomized trials are emphasized. The final version was endorsed by the scientific council of the LYSA. The expert panel recommends a risk-adapted strategy (conventional treatment, or single/double transplantation and/or radiotherapy) based on three risk factors at progression (primary refractory disease, remission duration < 1 year, stage III/IV), and an early evaluation of salvage chemosensitivity, including 18fluorodeoxy glucose-positron emission tomography interpreted according to the Deauville scoring system. Most relapsed or refractory Hodgkin’s lymphoma patients chemosensitive to salvage should receive high-dose therapy and autologous stem-cell transplantation as standard. Efforts should be made to increase the proportion of chemosensitive patients by alternating non-cross-resistant chemotherapy lines or exploring the role of novel drugs.
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- 2013
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22. Daily practice management of myelodysplastic syndromes in France: data from 907 patients in a one-week cross-sectional study by the Groupe Francophone des Myélodysplasies
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Charikleia Kelaidi, Aspasia Stamatoullas, Odile Beyne-Rauzy, Emmanuel Raffoux, Bruno Quesnel, Agnes Guerci, François Dreyfus, Sabine Brechignac, Christian Berthou, Thomas Prebet, Yosr Hicheri, Maya Hacini, Jacques Delaunay, Marie-Pierre Gourin, Jean-Marie Camo, Hacene Zerazhi, Anne-Laure Taksin, Laurence Legros, Bachra Choufi, and Pierre Fenaux
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Background There is little published information on the everyday clinical management of myelodysplastic syndromes in real world practice.Design and Methods We conducted a cross-sectional study of all patients with myelodysplastic syndromes attending 74 French centers in a 1-week period for inpatient admission, day-hospital care or outpatient visits.Results Nine hundred and seven patients were included; 67.3% had lower-risk myelodysplastic syndromes (International Prognostic Scoring System: low or intermediate-1). Karyotype had been analyzed in 82.5% of the cases and was more often of intermediate or poor risk in patients under 65 years old compared with those who were older. Red blood cell transfusions accounted for as many as 31.4% of the admissions. Endogenous erythropoietin level was less than 500 IU/L in 88% of the patients tested. Erythroid stimulating agents had been or were being used in 36.8% of the lower risk patients, iron chelation in 31% of lower risk patients requiring red blood cell transfusions and lenalidomide in 41% of lower risk patients with del 5q. High-dose chemotherapy, hypomethylating agents, low dose cytarabine and allogeneic stem cell transplantation had been or were being used in 14.8%, 31.1%, 8.8% and 5.1%, respectively, of higher-risk patients.Conclusions Karyotype is now assessed in most patients with myelodysplastic syndromes, and patients under 65 years old may have more aggressive disease. Apart from erythroid-stimulating agents and, in higher-risk myelodysplastic syndromes, hypomethylating agents, specific treatments are used in a minority of patients with myelodysplastic syndromes and red blood cell transfusions still represent the major reason for hospital admission.
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- 2010
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23. Decitabine Versus Hydroxyurea for Advanced Proliferative Chronic Myelomonocytic Leukemia: Results of a Randomized Phase III Trial Within the EMSCO Network
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Raphael Itzykson, Valeria Santini, Sylvain Thepot, Lionel Ades, Cendrine Chaffaut, Aristoteles Giagounidis, Margot Morabito, Nathalie Droin, Michael Lübbert, Rosa Sapena, Stanislas Nimubona, Jean Goasguen, Eric Wattel, Gina Zini, Jose Miguel Torregrosa Diaz, Ulrich Germing, Anna Maria Pelizzari, Sophie Park, Nadja Jaekel, Georgia Metzgeroth, Francesco Onida, Robert Navarro, Andrea Patriarca, Aspasia Stamatoullas, Katharina Götze, Martin Puttrich, Sandra Mossuto, Eric Solary, Silke Gloaguen, Sylvie Chevret, Fatiha Chermat, Uwe Platzbecker, and Pierre Fenaux
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Cancer Research ,Oncology - Abstract
PURPOSE Hydroxyurea (HY) is a reference treatment of advanced myeloproliferative neoplasms. We conducted a randomized phase III trial comparing decitabine (DAC) and HY in advanced myeloproliferative chronic myelomonocytic leukemias (CMML). PATIENTS AND METHODS Newly diagnosed myeloproliferative CMML patients with advanced disease were randomly assigned 1:1 to intravenous DAC (20 mg/m2/d days 1-5) or HY (1-4 g/d) in 28-day cycles. The primary end point was event-free survival (EFS), events being death and acute myelomonocytic leukemia (AML) transformation or progression. RESULTS One-hundred seventy patients received DAC (n = 84) or HY (n = 86). Median age was 72 and 74 years, and median WBC count 32.5 × 109/L and 31.2 × 109/L in the DAC and HY arms, respectively. Thirty-three percent of DAC and 31% of HY patients had CMML-2. Patients received a median of five DAC and six HY cycles. With a median follow-up of 17.5 months, median EFS was 12.1 months in the DAC arm and 10.3 months in the HY arm (hazard ratio [HR], 0.83; 95% CI, 0.59 to 1.16; P = .27). There was no significant interaction between treatment effect and blast or platelet count, anemia, CMML Prognostic Scoring System, Groupe Francophone des Myelodysplasies, or CMML Prognostic Scoring System–mol risk. Fifty-three (63%) DAC patients achieved a response compared with 30 (35%) HY patients ( P = .0004). Median duration of response was similar in both arms (DAC, 16.3 months; HY, 17.4 months; P = .90). Median overall survival was 18.4 months in the DAC arm and 21.9 months in the HY arm ( P = .67). Compared with HY, DAC significantly reduced the risk of CMML progression or transformation to acute myelomonocytic leukemia (cause-specific HR, 0.62; 95% CI, 0.41 to 0.94; P = .005) at the expense of death without progression or transformation (cause-specific HR, 1.55; 95% CI, 0.82 to 2.9; P = .04). CONCLUSION Compared with HY, frontline treatment with DAC did not improve EFS in patients with advanced myeloproliferative CMML (ClinicalTrials.gov identifier: NCT02214407 ).
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- 2023
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24. Cardiovascular outcomes of patients treated for non-Hodgkin lymphoma with first-line doxorubicin-based chemotherapy
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Alexandra, Zduniak, Emilie, Lévêque, Anne, Perdrix, Pascaline, Etancelin, Anne-Lise, Ménard, Pascal, Lenain, Nathalie, Contentin, Louis-Ferdinand, Pépin, Stéphane, Leprêtre, Emilie, Lemasle, Hélène, Lanic, Aspasia, Stamatoullas-Bastard, Leila, Kammoun-Quique, Hervé, Tilly, Fabrice, Bauer, Fabrice, Jardin, and Vincent, Camus
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Cancer Research ,Oncology ,Hematology - Abstract
We conducted a single-center retrospective study to assess cardiovascular (CV) toxicity and treatment discontinuation for CV toxicity in diffuse large B-cell lymphoma (DLBCL) or follicular lymphoma (FL) patients treated with immunochemotherapy (R-CHOP-like). Between 2006 and 2017, 433 patients were included (DLBCL
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- 2022
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25. Final results of brentuximab vedotin combined with ifosfamide-carboplatin-etoposide in first refractory/relapsed Hodgkin lymphoma: a lymphoma study association phase I/II study
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Aspasia Stamatoullas, Hervé Ghesquières, Pierre Feugier, Marc André, Fabien Le Bras, Anne-Claire Gac, Cécile Borel, Thomas Gastinne, Philippe Quittet, Franck Morschhauser, Vincent Ribrag, Stephanie Guidez, Emmanuelle Nicolas-Virelizier, Alina Berriolo-Riedinger, Thierry Vander Borght, Véronique Edeline, Pauline Brice, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service d'hématologie, Groupe de Recherche sur les formes Injectables et les Technologies Associées - ULR 7365 (GRITA), and Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)
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relapse ,refractory ,Cancer Research ,autologous stem cell transplantation ,Oncology ,brentuximab vedotin ,[SDV]Life Sciences [q-bio] ,salvage chemotherapy ,ICE regimen ,Hematology ,Hodgkin lymphoma - Abstract
This phase I/II study assessed the combination of brentuximab vedotin (BV) with ifosfamide-carboplatin-etoposide (ICE) as a second-line therapy in refractory/relapsed (R/R) classical Hodgkin lymphoma (cHL) patients. Phase I study was designed to determine the maximum tolerated dose (MTD) of BV (10 patients) and phase II evaluated the rate of complete metabolic response (CMR) after 2 cycles of BV-ICE (42 patients). There were no dose-limiting toxicities (DLT) during phase I recommending BV 1.8 mg/kg for phase II. Twenty-six patients (61.9%) achieved CMR after 2 cycles of BV-ICE and 37 patients (88%) were transplanted. With a median follow-up of 38 months, the 3-year progression free survival (PFS) and overall survival (OS) rate were 64.3% and 100%, respectively. Hematological toxicities (81%) and infections (21%) were the most frequent adverse event encountered BV-ICE regimen is feasible with manageable toxicities and could be an alternative to other salvage treatments. : ClinicalTrials.gov identifier: NCT02686346.
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- 2022
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26. Prognostic relevance of sarcopenia, geriatric, and nutritional assessments in older patients with diffuse large B-cell lymphoma: results of a multicentric prospective cohort study
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Juliette, Pénichoux, primary, Hélène, Lanic, additional, Caroline, Thill, additional, Anne-Lise, Ménard, additional, Vincent, Camus, additional, Aspasia, Stamatoullas, additional, Emilie, Lemasle, additional, Stéphane, Leprêtre, additional, Pascal, Lenain, additional, Nathalie, Contentin, additional, Jerôme, Kraut-Tauzia, additional, Christophe, Fruchart, additional, Leila, Kammoun, additional, Gandhi, Damaj, additional, Agathe, Farge, additional, Caroline, Delette, additional, Romain, Modzelewski, additional, Sandrine, Vaudaux, additional, Louis-Ferdinand, Pépin, additional, Hervé, Tilly, additional, and Fabrice, Jardin, additional
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- 2023
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27. Red blood cell transfusion burden in myelodysplastic syndromes ( <scp>MDS</scp> ) with ring Sideroblasts ( <scp>RS</scp> ): A retrospective multicenter study by the Groupe Francophone des Myélodysplasies ( <scp>GFM</scp> )
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Claire Jouzier, Amina Cherait, Pascale Cony‐Makhoul, Jean‐François Hamel, Melanie Veloso, Sylvain Thepot, Thomas Cluzeau, Aspasia Stamatoullas, Alice Garnier, Agnès Guerci‐Bresler, Sophie Dimicoli‐Salazar, Gian Matteo Pica, Stéphane Cheze, Clémence Santana, Fatiha Chermat, Pierre Fenaux, and Sophie Park
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Myelodysplastic Syndromes ,Immunology ,Humans ,Immunology and Allergy ,Anemia ,Hematology ,Erythrocyte Transfusion ,Iron Chelating Agents ,Retrospective Studies - Abstract
MDS-RS patients are characterized by chronic anemia and a low risk of Acute Myeloid Leukemia (AML) progression and they generally become Red Blood Cell (RBC) transfusion dependent (TD).We performed a retrospective "real-life" observational study of 6 months in 100 MDS-RS TD patients, recruited in 12 French centers, to describe transfusion characteristics, and evaluate the frequency and causes of hospitalizations, health costs, and morbidity, associated with transfusion dependency, in a French population of RBC transfusion-dependent MDS-RS patients.79% of the patients had high transfusion burden (HTB) and 21% low transfusion burden (LTB). HTB patients had a longer disease duration (6 vs. 3.7 years, p = 0.0078), more frequent iron chelation (82% vs. 50%, p = 0.0052) and higher serum ferritin (p = 0.03). During the 6-month study period, 22% of the patients required inpatient hospitalization, 36% of them for symptomatic anemia requiring emergency RBC transfusion. The 6-month median transfusion costs, including the cost of the day care facility, transportation to and from the hospital, iron chelation, and lab tests, was 16,188€/patient.MDS-RS represents the archetypal type of chronically transfused lower-risk MDS. Most of those patients have a high transfusion burden and thus frequently need visits to the hospital's day care facility, and frequent hospitalizations, with an overall high median treatment cost. Those costs should be compared with costs of new treatments potentially able to avoid RBC transfusion dependence and to reduce the complications of chronic anemia in MDS-RS patients.
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- 2022
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28. Positron Emission Tomography–Driven Strategy in Advanced Hodgkin Lymphoma: Prolonged Follow-Up of the AHL2011 Phase III Lymphoma Study Association Study
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René-Olivier Casasnovas, Reda Bouabdallah, Pauline Brice, Julien Lazarovici, Hervé Ghesquieres, Aspasia Stamatoullas, Jehan Dupuis, Anne-Claire Gac, Thomas Gastinne, Bertrand Joly, Krimo Bouabdallah, Emmanuelle Nicolas-Virelizier, Pierre Feugier, Franck Morschhauser, David Sibon, Christophe Bonnet, Alina Berriolo-Riedinger, Véronique Edeline, Marie Parrens, Diane Damotte, Diane Coso, Marc André, Michel Meignan, Cédric Rossi, UCL - SSS/IREC/MONT - Pôle Mont Godinne, and UCL - (MGD) Service d'hématologie
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Adult ,Cancer Research ,Adolescent ,Neoplasms, Second Primary ,Middle Aged ,Vinblastine ,Hodgkin Disease ,Dacarbazine ,Bleomycin ,Young Adult ,Oncology ,Doxorubicin ,Vincristine ,Positron-Emission Tomography ,Procarbazine ,Antineoplastic Combined Chemotherapy Protocols ,Humans ,Prednisone ,Cyclophosphamide ,Etoposide ,Follow-Up Studies ,Neoplasm Staging - Abstract
PURPOSE The AHL2011 study (ClinicalTrials.gov identifier: NCT01358747 ) demonstrated that a positron emission tomography (PET)-driven de-escalation strategy after two cycles of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) provides similar progression-free survival (PFS) and overall survival (OS) and reduces early toxicity compared with a nonmonitored standard treatment. Here, we report, with a prolonged follow-up, the final study results. METHODS Patients with advanced Hodgkin lymphoma (stage III, IV, or IIB with mediastinum/thorax ratio > 0.33 or extranodal involvement) age 16-60 years were prospectively randomly assigned between 6 × BEACOPP and a PET-driven arm after 2 × BEACOPP delivering 4 × ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) in PET2– and 4 × BEACOPP in PET2+ patients. PET performed after four cycles of chemotherapy had to be negative to complete the planned treatment. RESULTS In total, 823 patients were enrolled including 413 in the standard arm and 410 in the PET-driven arm. With a 67.2-month median follow-up, 5-year PFS (87.5% v 86.7%; hazard ratio [HR] = 1.07; 95% CI, 0.74 to 1.57; P = .67) and OS (97.7% in both arms; HR = 1.012; 95% CI, 0.50 to 2.10; P = .53) were similar in both randomization arms. In the whole cohort, full interim PET assessment predicted patients' 5-year PFS (92.3% in PET2–/PET4–, 75.4% [HR = 3.26; 95% CI, 18.3 to 5.77] in PET2+/PET4– and 46.5% [HR = 12.4; 95% CI, 7.31 to 19.51] in PET4+ patients, respectively; P < .0001) independent of international prognosis score. Five-year OS was also affected by interim PET results, and PET2+/PET4– patients (93.5%; HR = 3.3; 95% CI, 1.07 to 10.1; P = .036) and PET4+ patients (91.9%; HR = 3.756; 95% CI, 1.07 to 13.18; P = .038) had a significant lower OS than PET2–/PET4– patients (98.2%). Twenty-two patients (2.7%) developed a second primary malignancy, 13 (3.2%) and 9 (2.2%) in the standard and experimental arms, respectively. CONCLUSION The extended follow-up confirms the continued efficacy and favorable safety of AHL2011 PET-driven strategy, which is noninferior to standard six cycles of BEACOPP. PET4 provides additional prognostic information to PET2 and allows identifying patients with particularly poor prognosis.
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- 2022
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29. Circulating tumor DNA in primary mediastinal large B-cell lymphoma versus classical Hodgkin lymphoma: a retrospective study
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Vincent, Camus, Mathieu, Viennot, Emilie, Lévêque, Pierre-Julien, Viailly, David, Tonnelet, Elena-Liana, Veresezan, Fanny, Drieux, Pascaline, Etancelin, Sydney, Dubois, Aspasia, Stamatoullas, Hervé, Tilly, Elodie, Bohers, and Fabrice, Jardin
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Adult ,Cancer Research ,Lymphoma, B-Cell ,Oncology ,Humans ,Lymphoma, Large B-Cell, Diffuse ,Hematology ,Hodgkin Disease ,Mediastinal Neoplasms ,Circulating Tumor DNA ,Retrospective Studies - Abstract
Few data exist concerning circulating tumor DNA (ctDNA) relevance in primary mediastinal B-cell lymphoma (PMBL). To explore this topic, we applied a 9-gene next-generation sequencing pipeline to samples from forty-four PMBL patients (median age 36.5 years). The primary endpoint was a similarity between paired biopsy/plasma mutational profiles. We detected at least one variant in 32 plasma samples (80%). The similarity between the biopsy and ctDNA genetic profiles for the 30 patients with paired mutated biopsy/plasma samples was greater than or equal to 80% in 19 patients (63.3%). We then compared PMBL ctDNA features with those of a cohort of Hodgkin lymphoma patients (
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- 2022
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30. Allogeneic hematopoietic cell transplantation for myelodysplastic syndrome unclassifiable – a retrospective study on behalf of the Chronic Malignancies Working Party of the EBMT
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Joanna Drozd-Sokolowska, Luuk Gras, Nienke Zinger, Mohsen Al Zahrani, Jakob Passweg, Jenny Byrne, Aloysius Ho, Xiao-jun Huang, Nicolaus Kröger, Jiri Mayer, Domenico Russo, Ann De Becker, Abdelghani Tbakhi, Aspasia Stamatoullas, Thomas Valerius, Patrick Hayden, Donal P. McLornan, Francesco Onida, Christof Scheid, Marie Robin, Ibrahim Yakoub-Agha, Hematology, and Faculty of Medicine and Pharmacy
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Transplantation ,myelodysplastic syndrome unclassifiable ,Hematology ,Allogeneic hematopoietic cell transplantation - Published
- 2023
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31. Work and education interruption in long-term Hodgkin lymphoma survivors : an analysis among patients from nine EORTC-LYSA trials
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Sidsel J. Juul, Sára Rossetti, Michal Kicinski, Marleen A. E. van der Kaaij, Francesco Giusti, Paul Meijnders, Berthe M. P. Aleman, John M. M. Raemaekers, Hanneke C. Kluin-Nelemans, Michele Spina, Christophe Fermé, Loïc Renaud, Olivier Casasnovas, Aspasia Stamatoullas, Marc André, Fabien Le Bras, Wouter J. Plattel, Michel Henry-Amar, Martin Hutchings, Maja V. Maraldo, UCL - SSS/IREC/MONT - Pôle Mont Godinne, and UCL - (MGD) Service d'hématologie
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education ,work ,Oncology ,employment ,Radiology, Nuclear Medicine and imaging ,Hematology ,General Medicine ,Human medicine ,survivorship ,Hodgkin lymphoma - Abstract
Background: Disease-specific studies on the impact of Hodgkin lymphoma (HL) on education or work interruption and resumption are lacking. Material and methods: In a cross-sectional study conducted among long-term HL survivors enrolled from 1964 to 2004 in nine randomised EORTC-LYSA trials, the interruption and resumption of education/work was investigated. Survivors alive 5-44 years after diagnosis who were studying or working at time of diagnosis were included (n = 1646). Patient and treatment characteristics were obtained from trial records. Education and work outcomes were collected using the Life Situation Questionnaire. Logistic regression was used to model education or work interruption; Cox regression was used to study resumption rates. Results: Among survivors studying at time of diagnosis (n = 323), 52% (95% CI: 46-57%) interrupted their education; however, it was resumed within 24 months by 92% (95% CI: 87-96%). The probability of interruption decreased with time: the more recent the treatment era, the lower the risk (OR 0.70 per 10 years, 95% CI: 0.49-1.01). Treatment with radiotherapy (yes vs. no) was associated with a higher education resumption rate (HR 2.01, 95% CI 1.07-3.78) whereas age, sex, stage, radiotherapy field and chemotherapy were not.Among survivors working at time of diagnosis (n = 1323), 77% (95% CI: 75-79%) interrupted their work. However, it was resumed within 24 months by 86% (95% CI: 84%-88%). Women were more likely to interrupt their work as compared to men (OR 1.90, 95% CI: 1.44-2.51) and, when interrupted, less likely to resume work (HR 0.70, 95% CI: 0.61-0.80). Survivors with a higher educational level were less likely to interrupt their work (OR 0.68 for university vs. no high school, 95% CI: 0.46-1.03); and when interrupted, more likely to resume work (HR 1.50 for university vs. no high school, 95% CI: 1.21-1.86). Increasing age was also associated with lower resumption rates (HR 0.62 for age ≥50 vs. 18-29 years, 95% CI: 0.41-0.94). Conclusion: An interruption in education/work was common among long-term HL survivors. However, most of the survivors who interrupted their studies or work had resumed their activities within 24 months. In this study, no associations between survivors' characteristics and failure to resume education were observed. Female sex, age ≥50 years, and a lower level of education were found to be associated with not resuming work after treatment for HL.
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- 2023
32. Prognostic value of baseline metabolic tumour volume in advanced-stage Hodgkin’s lymphoma
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Stéphanie Becker, Pierre Vera, Pierre Pinochet, Edgar Texte, Aspasia Stamatoullas-Bastard, and Sorina-Dana Mihailescu
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Adult ,Male ,Oncology ,BEACOPP ,medicine.medical_specialty ,medicine.medical_treatment ,Science ,Population ,Article ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Stage (cooking) ,education ,Survival analysis ,Retrospective Studies ,education.field_of_study ,Multidisciplinary ,medicine.diagnostic_test ,business.industry ,Middle Aged ,Prognosis ,medicine.disease ,Hodgkin's lymphoma ,Hodgkin Disease ,Progression-Free Survival ,Tumor Burden ,Lymphoma ,ABVD ,Positron emission tomography ,Positron-Emission Tomography ,Medicine ,Female ,business ,Hodgkin lymphoma ,medicine.drug - Abstract
Our aim was to evaluate the prognostic value of initial total metabolic tumour volume (TMTV) in a population of patients with advanced-stage Hodgkin’s lymphoma (HL). We retrospectively included 179 patients with stage IIb-III-IV Hodgkin’s disease who received BEACOPP or ABVD as the first-line treatment. The initial TMTV was determined using a semi-automatic method for each patient. We analysed its prognostic value in terms of 5-year progression-free survival (PFS), overall survival, and positron emission tomography (PET) response after two courses of chemotherapy. Considering all the treatments and using a threshold of 217 cm3, TMTV was predictive of 5-year PFS and PET response after two courses of chemotherapy. In multivariable analysis involving TMTV, IPI score, and the first treatment received, TMTV remained a baseline prognostic factor for 5-year PFS. In the subgroup of patients treated with BEACOPP with a threshold of 331 cm3, TMTV was predictive of PET response, but not 5-year PFS (p = 0.087). The combined analysis of TMTV and PET response enabled the individualisation of a subgroup of patients (low TMTV and complete response on PET) with a very low risk of recurrence. Baseline TMTV appears to be a useful independent prognostic factor for predicting relapse in advanced-stage HL in ABVD subgroup, with a tendency of survival curves separation in BEACOPP subgroup.
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- 2021
33. Employment situation among long-term Hodgkin lymphoma survivors in Europe: an analysis of patients from nine consecutive EORTC-LYSA trials
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Sidsel J. Juul, Sára Rossetti, Michal Kicinski, Marleen A. E. van der Kaaij, Francesco Giusti, Paul Meijnders, Berthe M. P. Aleman, John M. M. Raemaekers, Hanneke C. Kluin-Nelemans, Michele Spina, Christophe Fermé, Loïc Renaud, Olivier Casasnovas, Aspasia Stamatoullas, Marc André, Fabien Le Bras, Wouter J. Plattel, Michel Henry-Amar, Martin Hutchings, Maja V. Maraldo, UCL - SSS/IREC/MONT - Pôle Mont Godinne, and UCL - (MGD) Service d'hématologie
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Employment ,Work ,Sociology ,Oncology ,Oncology (nursing) ,Rehabilitation ,Survivorship ,Human medicine ,Biology ,Hodgkin lymphoma - Abstract
Purpose Little is known about the employment situation of long-term Hodgkin lymphoma (HL) survivors despite their young age at diagnosis and the favorable prognosis of the disease. In this cross-sectional study, we aim to describe the employment situation in a cohort of long-term HL survivors compared to the general population and investigate the associations with disease characteristics and treatment exposure. Methods HL survivors > 25 years (n = 1961) were matched 1:25 to controls (n = 49,025) from the European Union Labour Force Survey. Individual treatment information was obtained from trial records. Employment and socio-demographic characteristics were collected using the Life Situation Questionnaire. Logistic regression models were used to estimate associations between disease and treatment characteristics with employment status and work-related attitudes. Results At employment assessment, 69.7% of survivors (95% CI: 67.6-71.7%) were working; of these, 68.9% (95% CI: 66.3-71.3%) worked full-time, a figure comparable to that of controls (p value 0.17). The risk of not working was associated with increasing age at diagnosis, increasing age at survey, female sex, lower educational level, and relapse history. Of those who were at work during treatment, 16.8% (95% CI: 14.5-19.3%) stated their income had subsequently decreased, which was attributed to their HL by 65.4% (95% CI: 57.5-72.8). Among those not at work, 25.1% (95% CI: 20.7-29.8) survivors were disabled compared to only 14.5% (95% CI: 13.8-15.3%) of controls. Conclusions In this cohort of HL survivors, employment status was comparable to that of the general population. However, increasing age at follow-up, female sex, lower educational level, and relapse history are risk factors for unemployment, a perceived decrease in income, and disability. Implications for Cancer Survivors To further improve follow-up care, special attention should be paid to these vulnerable subgroups.
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- 2022
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34. Eprenetapopt Plus Azacitidine in TP53-Mutated Myelodysplastic Syndromes and Acute Myeloid Leukemia: A Phase II Study by the Groupe Francophone des Myélodysplasies (GFM)
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Blandine Beve, Rami S. Komrokji, Elsa Miekoutima, Jacqueline Lehmann-Che, Antoine F. Carpentier, Céline Berthon, Isabelle Madelaine, Thomas Cluzeau, Aspasia Stamatoullas, Ramy Rahmé, Anouk Walter-Petrich, Sylvie Chevret, Bruno Quesnel, Michael Loschi, Emmanuel Raffoux, David A. Sallman, Lise Willems, Habiba Attalah, Fatiha Chermat, Lionel Ades, Marie Sebert, Pierre Peterlin, Stefania Cuzzubbo, Odile Beyne Rauzy, Christian Recher, and Pierre Fenaux
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Oncology ,Cancer Research ,medicine.medical_specialty ,business.industry ,Myelodysplastic syndromes ,Azacitidine ,Phases of clinical research ,Myeloid leukemia ,medicine.disease ,hemic and lymphatic diseases ,Internal medicine ,medicine ,business ,medicine.drug - Abstract
PURPOSE TP53-mutated ( TP53m) myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) have very poor outcome irrespective of the treatment received, including 40% responses (20% complete remission [CR]) with azacitidine (AZA) alone, short response duration, and a median overall survival (OS) of approximately 6 months. Eprenetapopt (APR-246), a novel first-in-class drug, leads to p53 protein reconformation and reactivates its proapoptotic and cell-cycle arrest functions. PATIENTS AND METHODS This phase II study assessed the safety and efficacy of eprenetapopt in combination with AZA in untreated high or very high International Prognostic Scoring System-R TP53m MDS and AML patients. RESULTS Fifty-two TP53m patients (34 MDS, 18 AML [including seven with more than 30% blasts]) were enrolled. In MDS, we observed an overall response rate (ORR) of 62%, including 47% CR, with a median duration of response at 10.4 months. In AML, the ORR was 33% including 17% CR (27% and 0% CR in AML with less than and more than 30% marrow blasts, respectively). Seventy-three percent of responders achieved TP53 next-generation sequencing negativity (ie, variant allele frequency < 5%). The main treatment-related adverse events were febrile neutropenia (36%) and neurologic adverse events (40%), the latter correlating with a lower glomerular filtration rate at treatment onset ( P < .01) and higher age ( P = .05), and resolving with temporary drug interruption without recurrence after adequate eprenetapopt dose reduction. With a median follow-up of 9.7 months, median OS was 12.1 months in MDS, and 13.9 and 3.0 months in AML with less than and more than 30% marrow blasts, respectively. CONCLUSION In this very high-risk population of TP53m MDS and AML patients, eprenetapopt combined with AZA was safe and showed potentially higher ORR and CR rate, and longer OS than reported with AZA alone.
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- 2021
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35. Prognostic relevance of lymphocyte-to-monocyte ratio in primary myelodysplastic syndromes: a single center experience
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Sylvie Daliphard, Aspasia Stamatoullas, Juliette Pénichoux, Gérard Buchonnet, Hervé Tilly, Vincent Camus, Daphné Krzisch, Emilie Lemasle, Sydney Dubois, Fabrice Jardin, Dominique Penther, Christian Bastard, Anne-Lise Menard, Hélène Lanic, Nathalie Contentin, Pascal Lenain, and Stéphane Leprêtre
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Oncology ,Cancer Research ,medicine.medical_specialty ,Lymphocyte ,Disease ,Single Center ,Monocytes ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,hemic and lymphatic diseases ,Internal medicine ,Humans ,Medicine ,Lymphocytes ,Retrospective Studies ,Acute leukemia ,business.industry ,Myelodysplastic syndromes ,Monocyte ,Hematology ,Prognosis ,medicine.disease ,medicine.anatomical_structure ,Myelodysplastic Syndromes ,030220 oncology & carcinogenesis ,business ,030215 immunology - Abstract
In myelodysplastic syndromes (MDS), the prognosis of the disease is related partly to the complications of blood cytopenias, and partly to the risk of transformation, over time, into acute leukemia...
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- 2021
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36. Targeted genotyping of circulating tumor DNA for classical Hodgkin lymphoma monitoring: a prospective study
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J. Lequesne, Marie Cornic, Stéphane Leprêtre, Lucile Bessi, Elena-Liana Veresezan, Elodie Bohers, Justine Loret, Anne-Lise Menard, Hervé Tilly, Nathalie Contentin, Pierre-Julien Viailly, Aspasia Stamatoullas, Vincent Camus, Stéphanie Becker, Jean-Michel Picquenot, Hélène Lanic, Pierre Decazes, Sydney Dubois, Pascaline Etancelin, Pascal Lenain, Mathieu Viennot, Bénédicte Marcq, Fabrice Jardin, Emilie Lemasle, Lucie Burel, Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Service de médecine nucléaire [Rouen], and CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
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Adult ,Oncology ,medicine.medical_specialty ,Genotype ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,Vinblastine ,Article ,Circulating Tumor DNA ,Bleomycin ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Biomarkers, Tumor ,Humans ,Medicine ,Hodgkin's Lymphoma ,Prospective Studies ,Liquid biopsy ,Prospective cohort study ,Genotyping ,Aged ,Retrospective Studies ,Aged, 80 and over ,Minimal Residual Disease ,Chemotherapy ,Cytogenetics and Molecular Genetics ,business.industry ,Editorials ,Retrospective cohort study ,Hematology ,Middle Aged ,Hodgkin's lymphoma ,medicine.disease ,Hodgkin Disease ,Minimal residual disease ,3. Good health ,Dacarbazine ,ABVD ,Doxorubicin ,030220 oncology & carcinogenesis ,Mutation ,business ,030215 immunology ,medicine.drug - Abstract
The relevance of circulating tumor DNA (ctDNA) analysis as a liquid biopsy and minimal residual disease tool in the management of classical Hodgkin lymphoma (cHL) patients was demonstrated in retrospective settings and remains to be confirmed in a prospective setting. We developed a targeted Next-Generation sequencing (NGS) panel for fast analysis (AmpliSeq® technology) of nine commonly mutated genes in biopies and ctDNA of cHL patients. We then conducted a prospective trial to assess ctDNA follow-up at diagnosis and after two cycles (C2) of chemotherapy. Sixty cHL patients treated by first line conventional chemotherapy (BEACOPPescalated [21.3%], ABVD/ABVD-like [73.5%] and other regimens [5.2%, for elderly patients]) were assessed in this noninterventional study. The median age of the patients was 33.5 years (range: 20-86). Variants were identified in 42 (70%) patients. Mutations of NFKBIE, TNFAIP3, STAT6, PTPN1, B2M, XPO1, ITPKB, GNA13 and SOCS1 were found in 13.3%, 31.7%, 23.3%, 5%, 33.3%, 10%, 23.3%, 13.3% and 50% of patients, respectively. ctDNA concentration and genotype were correlated with clinical characteristics and presentation. Regarding early therapeutic response, 45 patients (83%, not available [NA] =6) had a negative positron emission tomography (PET) after C2 (Deauville Score 1-3). The mean of DeltaSUVmax after C2 was -78.8%. ctDNA after C2 was analysed in 54 patients (90%). ctDNA became rapidly undetectable in all cases after C2. Variant detection in ctDNA is suitable to depict the genetic features of cHL at diagnosis and may help to assess early treatment response, in association with PET. Clinical Trial reference: NCT02815137.
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- 2020
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37. Composite and sequential lymphoma between classical Hodgkin lymphoma and primary mediastinal lymphoma/diffuse large B‐cell lymphoma, a clinico‐pathological series of 25 cases
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Violaine Safar, Caroline Regny, Sylvain Lamure, Alexandra Traverse-Glehen, Catherine Chassagne-Clément, Guillaume Aussedat, Pierre Hirsch, Guillaume Manson, Marie Le Cann, Emmanuelle Nicolas-Virelizier, Jean-Marie Michot, Juliette Fontaine, Patrick Tas, Aspasia Stamatoullas, Christiane Copie-Bergman, Clémentine Sarkozy, Hervé Ghesquières, Thierry Jo Molina, Richard Lemal, Jean-Michel Picquenot, Camille Laurent, Albane Ledoux-Pilon, Gilles Salles, Role of intra-Clonal Heterogeneity and Leukemic environment in ThErapy Resistance of chronic leukemias (CHELTER), and Université Clermont Auvergne [2017-2020] (UCA [2017-2020])
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Adult ,Male ,Pathology ,medicine.medical_specialty ,Adolescent ,Diagnosis, Differential ,Extranodal Disease ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,immune system diseases ,hemic and lymphatic diseases ,medicine ,Classical Hodgkin lymphoma ,Humans ,Pathological ,ComputingMilieux_MISCELLANEOUS ,Aged ,Retrospective Studies ,Aged, 80 and over ,Series (stratigraphy) ,business.industry ,[SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology ,Hematology ,Middle Aged ,medicine.disease ,Hodgkin Disease ,3. Good health ,Lymphoma ,Primary Mediastinal Lymphoma ,030220 oncology & carcinogenesis ,Female ,Clinico pathological ,Lymphoma, Large B-Cell, Diffuse ,business ,Diffuse large B-cell lymphoma ,030215 immunology - Abstract
Composite and sequential lymphomas involving both classical Hodgkin lymphoma (CHL) and primary mediastinal B-cell lymphoma (PMBCL) are rare phenomena. Beyond the relevant biological interest raised by these cases, treatments and outcome data are poorly covered in the recent literature. This retrospective analysis describes the pathological and clinical characteristics of 10 composite and 15 sequential cases included after a central pathological review. At diagnosis, 70% of the composite lymphomas presented a disseminated and extranodal disease. Among the 15 sequential lymphomas, 12 were CHL at first occurrence and three were PMBCL. Based on their clinical evolution, these sequential lymphomas could be divided into early (i.e., diagnosis of second lymphoma within a year) and late [(i.e., a second lymphoma occurrence occurring after a long period of complete remission]). All composite cases were alive in complete remission after a median follow-up of 34 months. If the early sequential lymphoma presented a particularly poor outcome with a median overall survival shorter than one year, the late cases were efficiently salvaged. Further molecular studies are needed to describe the underlying biology of these rare diseases, possibly representing the extreme of tumour cell plasticity found in grey-zone lymphoma.
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- 2020
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38. High Prevalence of Pre-Existing Sarcopenia in Critically Ill Patients with Hematologic Malignancies Admitted to the Intensive Care Unit for Sepsis or Septic Shock
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Antoine Herault, Emilie Lévêque, Simon Draye-Carbonnier, Pierre Decazes, Alexandra Zduniak, Romain Modzelewski, Julie Libraire, Najate Achamrah, Anne-Lise Ménard, Pascal Lenain, Nathalie Contentin, Maximilien Grall, Stéphane Leprêtre, Emilie Lemasle, Hélène Lanic, Mustafa Alani, Aspasia Stamatoullas-Bastard, Hervé Tilly, Fabrice Jardin, Fabienne Tamion, and Vincent Camus
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History ,Nutrition and Dietetics ,Polymers and Plastics ,Endocrinology, Diabetes and Metabolism ,Business and International Management ,Industrial and Manufacturing Engineering - Published
- 2022
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39. Dissociated humoral and cellular immune responses after a three-dose schema of BNT162b2 vaccine in patients receiving anti-CD20 monoclonal antibody maintenance treatment for B-cell lymphomas
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Sydney Dubois, Doriane Richard, Louis-Ferdinand Pepin, Marion Carette, Sophie Candon, Nathalie Contentin, Stéphane Leprêtre, Emilie Leveque, Aspasia Stamatoullas, Florian Bouclet, Jean-Christophe Plantier, Alain Dalleac, Edwige Boulet, Veronique Lemee, Pascaline Etancelin, Anne-Lise Menard, Cedric Paquin, Hélène Lanic, Manuel Etienne, Hervé Tilly, Victor Bobée, Fabrice Jardin, Vincent Camus, Nathalie Cardinael, Mustafa Alani, and Emilie Lemasle
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Immunity, Cellular ,Vaccines ,Lymphoma, B-Cell ,medicine.drug_class ,business.industry ,Antibodies, Monoclonal ,Hematology ,Monoclonal antibody ,Antibodies, Viral ,Schema (genetic algorithms) ,medicine.anatomical_structure ,Immune system ,Immunology ,medicine ,Humans ,In patient ,Anti cd20 ,business ,B cell ,BNT162 Vaccine - Published
- 2021
40. A phase II study of guadecitabine in higher-risk myelodysplastic syndrome and low blast count acute myeloid leukemia after azacitidine failure
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Sophie Park, Anne Banos, Cendrine Chaffaut, Cecile Bally, Kamel Laribi, Laurence Legros, Aline Renneville, Pierre Fenaux, Emmanuel Gyan, Eric Wattel, Marie Sebert, Marie-Pierre Gourin, Sylvie Chevret, Claude Preudhomme, Simone Jueliger, Fatiha Chermat, Pierre Peterlin, Olivier Nibourel, Odile Beyne-Rauzy, Lionel Ades, Rosa Sapena, Aspasia Stamatoullas, Luke Bevan, and Laurence Sanhes
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Male ,Risk ,medicine.medical_specialty ,Azacitidine ,Decitabine ,Gastroenterology ,Article ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Internal medicine ,medicine ,Humans ,Survival analysis ,Aged ,business.industry ,Myeloid leukemia ,Hematology ,medicine.disease ,Survival Analysis ,Leukemia ,Leukemia, Myeloid, Acute ,Treatment Outcome ,Hypomethylating agent ,International Prognostic Scoring System ,Myelodysplastic Syndromes ,Female ,business ,030215 immunology ,medicine.drug - Abstract
High-risk myelodysplastic syndrome/acute myeloid leukemia patients have a very poor survival after azacitidine failure. Guadecitabine (SGI-110) is a novel subcutaneous hypomethylating agent which results in extended decitabine exposure. This multicenter phase II study evaluated the efficacy and safety of guadecitabine in high-risk myelodysplastic syndrome and low blast count acute myeloid leukemia patients refractory or relapsing after azacitidine. We included 56 patients with a median age of 75 years [Interquartile Range (IQR) 69-76]. Fifty-five patients received at least one cycle of guadecitabine (60 mg/m2/d subcutaneously days 1-5 per 28-day treatment cycles), with a median of 3 cycles (range, 0-27). Eight (14.3%) patients responded, including two complete responses; median response duration was 11.5 months. Having no or few identified somatic mutations was the only factor predicting response (P=0.035). None of the 11 patients with TP53 mutation responded. Median overall survival was 7.1 months, and 17.9 months in responders (3 of whom had overall survival >2 years). In multivariate analysis, IPSS-R (revised International Prognostic Scoring System) score other than very high (P=0.03) primary versus secondary azacitidine failure (P=0.01) and a high rate of demethylation in blood during the first cycle of treatment (P=0.03) were associated with longer survival. Thus, guadecitabine can be effective, sometimes yielding relatively prolonged survival, in a small proportion of high-risk myelodysplastic syndrome/low blast count acute myeloid leukemia patients who failed azacitidine. (Trial registered at clinicaltrials.gov identifier: 02197676).
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- 2019
41. Relapsed and refractory classical Hodgkin lymphoma: could virotherapy help solve the equation?
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Julien Lazarovici, Clémentine Sarkozy, Vincent Ribrag, Stéphane Champiat, Aspasia Stamatoullas, Jean-Marie Michot, Fabrice Jardin, Aurélien Marabelle, and Selma Addou
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Oncology ,medicine.medical_specialty ,Epstein-Barr Virus Infections ,Herpesvirus 4, Human ,medicine.medical_treatment ,030231 tropical medicine ,Immunology ,Review ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Refractory ,immune system diseases ,Internal medicine ,hemic and lymphatic diseases ,medicine ,Classical Hodgkin lymphoma ,Immunology and Allergy ,Humans ,030212 general & internal medicine ,Virotherapy ,Pharmacology ,Oncolytic Virotherapy ,Chemotherapy ,business.industry ,Epstein–Barr virus ,Hodgkin Disease ,Oncolytic virus ,Radiation therapy ,Oncolytic Viruses ,Hodgkin lymphoma ,business - Abstract
Classical Hodgkin lymphoma is a neoplastic hematological disease. Standard first-line therapy, including chemotherapy and radiotherapy, is curative in >85% of early-stage patients, with a 5-year survival rate of >95%. However, approximately 15% of patients have hard-to-treat lymphoma with poor outcomes, and new treatment strategies are needed for these young adults. There are several well-documented cases in the medical literature on hematologic cancer remission following natural human viral infections. Therefore, hoping to reproduce these spontaneous tumor regressions, researchers have been investigating various viruses with oncolytic properties. There is a high rationale for using virotherapy in the treatment of Hodgkin lymphoma, in which tumor cells are often infected with the Epstein-Barr virus. Modern viral technologies and current knowledge about the relationship between viruses and cancer could accelerate the discovery of effective viral oncolytic therapies. This article reviews the use of oncolytic viruses as innovative therapies for treating Hodgkin lymphoma.
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- 2021
42. AMAHRELIS : ADCETRIS MAINTENANCE AFTER AUTOLOGOUS STEM CELL TRANSPLANTATION IN HODGKIN LYMPHOMA : A REAL LIFE STUDY FROM SFGMTC AND LYSA GROUPS
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C. Borel, Julien Lazarovici, Didier Bouscary, David Sibon, A. Cottereau, Marie T Rubio, Guillaume Sicard, Luc Mathieu Fornecker, Aspasia Stamatoullas, Paul Deschamps, Herve Ghesquieres, Barbara Burroni, N. Raus, Guillaume Cartron, L. Clement, Bénédicte D’Eau, Pauline Brice, Salim Kanoun, S. Amorin, Patricia Franchi, M. Rocquet, A. Marouf, Adrien Chauchet, R. Gille, Jerome Tamburini, D. Cavalieri, Michel Meignan, Olivier Casasnovas, Thomas Gastinne, and Mohammad Hammoud
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Oncology ,Cancer Research ,medicine.medical_specialty ,Autologous stem-cell transplantation ,business.industry ,Internal medicine ,medicine ,Hodgkin lymphoma ,Hematology ,General Medicine ,Life study ,business - Published
- 2021
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43. BRENTUXIMAB VEDOTIN AS CONSOLIDATION TREATMENT IN PATIENTS WITH STAGE I/II CLASSICAL HODGKIN'S LYMPHOMA AND A POSITIVE FDG‐PET AFTER 2 CYCLES OF ABVD: A LYSA PHASE 2 STUDY
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Julien Lazarovici, Michel Meignan, Driss Chaoui, Hervé Ghesquières, C. Borel, Alain Delmer, Christophe Bonnet, T. Lamy, Benoit Tessoulin, A. Traverse Glehen, Anne-Claire Gac, Pierre Feugier, Kamal Bouabdallah, Aspasia Stamatoullas, F. Bras, Pauline Brice, Olivier Casasnovas, J. M. Shiano del colella, Luc‐M. Fornecker, Thomas Gastinne, and H. Moatti
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Oncology ,Cancer Research ,medicine.medical_specialty ,Consolidation (soil) ,business.industry ,Phases of clinical research ,Hematology ,General Medicine ,Classical Hodgkin's Lymphoma ,Stage i ii ,ABVD ,Internal medicine ,medicine ,In patient ,Brentuximab vedotin ,business ,medicine.drug - Published
- 2021
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44. SUV max -based assessment of PET response shows a superior specificity to Deauville criteria for predicting recurrence in Hodgkin’s lymphoma
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Stéphanie Becker, Edgar Texte, Aspasia Stamatoullas, Hervé Tilly, J. Lequesne, Fabrice Jardin, Pierre Vera, Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), and Normandie Université (NU)
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Oncology ,Cancer Research ,medicine.medical_specialty ,Optimal cutoff ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Hodgkin’s Lymphoma ,Deauville score ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,tumor/liver ratio ,18fdg pet ,deltaSUVmax ,High rate ,Chemotherapy ,business.industry ,Hematology ,Therapeutic evaluation ,Hodgkin's lymphoma ,medicine.disease ,3. Good health ,Lymphoma ,PET ,030220 oncology & carcinogenesis ,Cohort ,business ,030215 immunology - Abstract
International audience; One of the limitations of 18FDG PET/CT for therapeutic evaluation in Hodgkin's Lymphoma is the relatively high rate of false positive uptake. SUVmax reduction (ΔSUVmax) and tumor/liver ratio (TLr) are promising tools for response assessment in lymphoma. We determined the optimal cutoff values for ΔSUVmax and TLr and compared them to Deauville score (DS) after two and four cycles chemotherapy (PET2 and PET4 respectively) and at the end of treatment PET (PETeot) on a cohort of 362 patients. TLr showed better diagnostic performances than DS for predicting 5-year progression-free survival (PFS), especially on early PET/CT assessments. Positive predictive values at PET2 for TLr, ΔSUVmax and DS were 51%, 34% and 31% respectively. On the multivariable analysis, significant predictive factors of PFS were TLr (at PET2, PET4 and PETeot) and ΔSUVmax (at PET4 and PETeot). DS was not significantly associated with PFS at any PET timing.
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- 2021
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45. Eprenetapopt Plus Azacitidine in
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Thomas, Cluzeau, Marie, Sebert, Ramy, Rahmé, Stefania, Cuzzubbo, Jacqueline, Lehmann-Che, Isabelle, Madelaine, Pierre, Peterlin, Blandine, Bève, Habiba, Attalah, Fatiha, Chermat, Elsa, Miekoutima, Odile Beyne, Rauzy, Christian, Recher, Aspasia, Stamatoullas, Lise, Willems, Emmanuel, Raffoux, Céline, Berthon, Bruno, Quesnel, Michael, Loschi, Antoine F, Carpentier, David A, Sallman, Rami, Komrokji, Anouk, Walter-Petrich, Sylvie, Chevret, Lionel, Ades, and Pierre, Fenaux
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Adult ,Aged, 80 and over ,Leukemia, Myeloid, Acute ,Quinuclidines ,Myelodysplastic Syndromes ,Antineoplastic Combined Chemotherapy Protocols ,Mutation ,Azacitidine ,Humans ,Middle Aged ,Tumor Suppressor Protein p53 ,Aged - Abstract
This phase II study assessed the safety and efficacy of eprenetapopt in combination with AZA in untreated high or very high International Prognostic Scoring System-RFifty-twoIn this very high-risk population of
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- 2021
46. SUV
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Edgar, Texte, Justine, Lequesne, Hervé, Tilly, Fabrice, Jardin, Pierre, Vera, Aspasia, Stamatoullas, and Stéphanie, Becker
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Fluorodeoxyglucose F18 ,Positron Emission Tomography Computed Tomography ,Positron-Emission Tomography ,Humans ,Neoplasm Recurrence, Local ,Prognosis ,Hodgkin Disease ,Progression-Free Survival - Abstract
One of the limitations of
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- 2020
47. Outcomes after intensive care unit admission in newly diagnosed diffuse large B-cell lymphoma patients: A real-life study
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J. Lequesne, Aspasia Stamatoullas-Bastard, Louis-Ferdinand Pepin, Anne-Lise Menard, Vincent Camus, Emilie Lemasle, Alexandra Zduniak, Hervé Tilly, Fabienne Tamion, Fabrice Jardin, Nathalie Contentin, Sorina-Dana Mihailescu, Pascal Lenain, Hélène Lanic, and Stéphane Leprêtre
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Male ,medicine.medical_specialty ,health care facilities, manpower, and services ,Disease-Free Survival ,law.invention ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,Patient Admission ,law ,hemic and lymphatic diseases ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Hospital Mortality ,Cyclophosphamide ,Aged ,Retrospective Studies ,Septic shock ,business.industry ,Retrospective cohort study ,Hematology ,General Medicine ,Middle Aged ,medicine.disease ,Intensive care unit ,Survival Rate ,Regimen ,Intensive Care Units ,Respiratory failure ,Doxorubicin ,Vincristine ,030220 oncology & carcinogenesis ,Cohort ,Prednisone ,Female ,Lymphoma, Large B-Cell, Diffuse ,business ,Rituximab ,Diffuse large B-cell lymphoma ,030215 immunology - Abstract
We conducted a retrospective study to analyze the prognostic factors impacting the overall survival (OS) and progression-free survival (PFS) of diffuse large B-cell lymphoma (DLBCL) patients undergoing first-line therapy and admitted to intensive care unit (ICU) compared to a control cohort who did not required ICU admission. Between January 1, 2008, and December 31, 2018, 828 patients were diagnosed with DLBCL at our institution, including 72 patients who were required ICU admission during disease course. Among them, forty-five patients undergoing homogeneous first-line therapy with /R-CHOP-like regimen and ICU-admitted were selected for the present analysis. Control "non-ICU" DLBCL patients were matched by age, IPI score and treatment received. The median age at ICU admission was 65 years, 97.8% of patients displayed advanced-stage disease (III/IV), and 84.4% had a high IPI score (3-5). The main reasons for ICU admission were acute respiratory failure (40.0%) and septic shock (33.3%). The ICU mortality rate was 33.3%. The 2-year PFS was lower in ICU survivors patients than in non-ICU patients: 31.7% (95% CI 18.5-54.1) vs 60.8% (95% CI 51.2-72.1, P = .00049). Admission to the ICU is an event that clearly impacts the outcomes of patients with DLBCL, until 2 years after the event. ICU prognosis seems mainly related to critical patient severity at admission rather than lymphoma-related prognostic factors (IPIs), suggesting that ICU admission criteria should not be based only on the lymphoma prognosis.
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- 2020
48. Outcome of lower-risk myelodysplastic syndrome with ring sideroblasts (MDS-RS) after failure of erythropoiesis- stimulating agents
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Valeria Santini, Ioannis Kotsianidis, Rami S. Komrokji, Ulrich Germing, Guillermo Sanz, Katharina Götze, Maria Diez Campelo, Aspasia Stamatoullas, David P. Steensma, Enrico Balleari, Pierre Fenaux, Agnès Guerci-Bresler, Sophie Park, Andrea Toma, Charikleia Kelaidi, Jean-François Hamel, Mikkael A. Sekeres, and Sylvain Thepot
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Oncology ,Male ,Cancer Research ,medicine.medical_specialty ,Activin Receptors, Type II ,Recombinant Fusion Proteins ,Kaplan-Meier Estimate ,Lower risk ,Outcome (game theory) ,Internal medicine ,medicine ,Humans ,Treatment Failure ,Erythropoietin ,Lenalidomide ,Aged ,Proportional Hazards Models ,Salvage Therapy ,Myelodysplastic Syndrome with Ring Sideroblasts ,business.industry ,Hematology ,Anemia, Sideroblastic ,Immunoglobulin Fc Fragments ,Ferritins ,Azacitidine ,Disease Progression ,Hematinics ,Erythropoiesis ,Female ,business ,Erythrocyte Transfusion ,Follow-Up Studies - Published
- 2020
49. Vasculitis associated with myelodysplastic syndrome and chronic myelomonocytic leukemia: French multicenter case-control study
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Jean-Sébastien Allain, Laure Swiader, Pierre Peterlin, Emmanuel Dao, Carole Philipponnet, Pierre Fenaux, Alexis Régent, Sylvain Thepot, Eric Solary, Philippe Guilpain, Benjamin Terrier, Noemie Jourde Chiche, Rolande Cohen-Valensi, Ygal Benhamou, On behalf Minhemon, Anne Laure Roupie, Jonathan Broner, Amadou Konate, Matthieu Wemeau, Guillaume Bussone, Matthieu Ponsoye, J. Galland, Aline Tanguy-Schmidt, Marielle Roux-Sauvat, Guilhem Cavaille, Xavier Puéchal, Olivier Fain, Azeddine Dellal, Nadia Baati, Hubert de Boysson, Maud D'Aveni, Vincent Jachiet, Aspasia Stamatoullas-Bastard, Constance Lahuna, Lionel Ades, Lenaig Le Clech, Arsène Mekinian, Alexis Guédon, Marc Lambert, Achille Aouba, Anne Parcelier, Sélim Corm, J. Seguier, Snfmi., Mathilde Versini, Emmanuel Ledoult, Matthieu Groh, Marc Ruivard, Fabrice Carrat, Benoit de Renzis, Julien Rossignol, Lise Willems, François Maurier, Anne Marfaing Koka, Nicolas Schleinitz, Viviane Queyrel, Cristina Belizna, Valérie Noc, Andrei Tchirkov, Louis Terriou, Grégoire Martin de Frémont, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), and Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
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Adult ,Male ,medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,Giant Cell Arteritis ,Chronic myelomonocytic leukemia ,Gastroenterology ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Rheumatology ,hemic and lymphatic diseases ,Internal medicine ,Medicine ,Humans ,030212 general & internal medicine ,ComputingMilieux_MISCELLANEOUS ,Aged ,Retrospective Studies ,030203 arthritis & rheumatology ,Aged, 80 and over ,Acute leukemia ,business.industry ,Polyarteritis nodosa ,Case-control study ,Leukemia, Myelomonocytic, Chronic ,Odds ratio ,Middle Aged ,medicine.disease ,3. Good health ,Giant cell arteritis ,Anesthesiology and Pain Medicine ,International Prognostic Scoring System ,Case-Control Studies ,Myelodysplastic Syndromes ,Female ,business ,Vasculitis - Abstract
Introduction Our objective was to evaluate characteristics, treatment and outcome of vasculitis associated with myelodysplastic syndrome (MDS) and chronic myelomonicytic leukemia (CMML) Patients and Methods Retrospective descriptive analysis of MDS/CMML-related vasculitis and comparison with MDS/CMML patients without dysimmune features. Results Seventy patients with vasculitis and MDS/CMML were included, with median age of 71.5 [21–90] years and male/female ratio of 2.3. Vasculitis was diagnosed prior to MDS/CMML in 31 patients (44%), and after in 20 patients. In comparison with MDS/CMML without autoimmune/inflammatory features, vasculitis with MDS/MPN showed no difference in MDS/CMML subtypes distribution nor International Prognostic Scoring System and CMML-specific prognostic (IPSS/CPSS) scores. Vasculitis subtypes included Giant cell arteritis in 24 patients (34%), Behcet's-like syndrome in 11 patients (20%) and polyarteritis nodosa in 6 patients (9%). Glucocorticoids (GCs) were used as first-line therapy for MDS/CMML vasculitis in 64/70 patients (91%) and 41 (59%) received combined immunosuppressive therapies during the follow-up. After a median follow-up of 33.2 months [1–162], 31 patients (44%) achieved sustained remission. At least one relapse occurred in 43 patients (61%). Relapse rates were higher in patients treated with conventional Disease Modifying Anti-Rheumatic Drug (DMARDs) (odds ratio 4.86 [95% CI 1.38 - 17.10]), but did not differ for biologics (odds ratio 0.59 [95% CI 0.11–3.20]) and azacytidine (odds ratio 1.44 [95% CI 0.21–9.76]) than under glucocorticoids. Overall survival in MDS/CMML vasculitis was not significantly different from MDS/CMML patients without autoimmune/inflammatory features (p = 0.5), but acute leukemia progression rates were decreased (log rank Conclusion This study shows no correlation of vasculitis diagnoses with subtypes and severity of MDS/CMML, and no significant impact of vasculitis on overall survival. Whereas conventional DMARDs seem to be less effective, biologics or azacytidine therapy could be considered for even low-risk MDS/CMML vasculitis.
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- 2020
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50. Patient and physician preferences for first‐line treatment of classical Hodgkin lymphoma in Germany, France and the United Kingdom
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Paul J Bröckelmann, Mehul Dalal, Timothy M Illidge, Dirk Huebner, Kerstin Mueller, Suzanne McMullen, Ashish Gautam, Erin Zagadailov, J Ben Wilson, Aspasia Stamatoullas, and Sarah Goring
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Oncology ,BEACOPP ,Male ,medicine.medical_treatment ,Procarbazine ,0302 clinical medicine ,Prednisone ,Germany ,Antineoplastic Combined Chemotherapy Protocols ,Practice Patterns, Physicians' ,Brentuximab vedotin ,Manchester Cancer Research Centre ,Haematological Malignancy ,Patient Preference ,Hematology ,Middle Aged ,Hodgkin Disease ,Vinblastine ,Survival Rate ,Vincristine ,030220 oncology & carcinogenesis ,Female ,France ,medicine.drug ,Research Paper ,Adult ,medicine.medical_specialty ,Dacarbazine ,Disease-Free Survival ,03 medical and health sciences ,patient and physician preferences ,Bleomycin ,Internal medicine ,medicine ,Humans ,Adverse effect ,Cyclophosphamide ,Aged ,business.industry ,ResearchInstitutes_Networks_Beacons/mcrc ,discrete choice experiment ,ABVD ,United Kingdom ,Cross-Sectional Studies ,Doxorubicin ,business ,Hodgkin lymphoma ,030215 immunology - Abstract
Summary First‐line treatments for classical Hodgkin lymphoma (HL) include ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) and BEACOPP escalated (escalated dose bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, prednisone). To further improve overall outcomes, positron emission tomography‐driven strategies and ABVD or BEACOPP variants incorporating the antibody‐drug conjugate brentuximab vedotin (BV) or anti‐PD1 antibodies are under investigation in advanced‐stage patients. The present study aimed to elicit preferences for attributes associated with ABVD, BEACOPP escalated and BV‐AVD (BV, adriamycin, vinblastine and dacarbazine) among patients and physicians. Cross‐sectional online discrete choice experiments were administered to HL patients (n = 381) and haematologists/oncologists (n = 357) in France, Germany and the United Kingdom. Included attributes were progression‐free survival (PFS), overall survival (OS), and the risk of neuropathy, lung damage, infertility and hospitalisation due to adverse events. Whereas 5‐year PFS and OS were the most important treatment attributes to patients, the relative importance of each attribute and preference weights for each level varied among physicians according to the description of the hypothetical patient for whom treatment was recommended. PFS and OS most strongly influenced physicians’ recommendations when considering young female patients who did not want children or young male patients. Infertility was more important to physicians’ treatment decision than PFS when considering young women with unknown fertility preferences, whereas hospitalisations due to adverse events played the largest role in treatment decisions for older patients.
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- 2018
- Full Text
- View/download PDF
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