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1. Retour à la vie « normale » après traitement d’un cancer

Author

Laurent Degos, Nordlinger Bernard, Dejean-Assemat Anne, Couturier Daniel, Duffau Hugues, Montagnier Luc, Vivier Éric, Aurengo André, Schaison Gérard, Rochefort Henri, Germain Michel, Sancho-Garnier Hélène, Le Cesne Axel, Puisseux Alain, Blay Jean-Yves, Triboulet Jean Pierre, Dreno Brigitte, Leverger Guy, Degos Laurent, Jaeck Daniel, Rouëssé Jacques, Jacques Rouëssé, Jean Pierre Triboulet, Beani Jean-Claude, Jeanteur Philippe, Richard Villet, Huriet Claude, and Claude Huriet

Subjects
03 medical and health sciences, 030219 obstetrics & reproductive medicine, 0302 clinical medicine, 030220 oncology & carcinogenesis, General Medicine
Abstract

RESUME L’incidence du cancer et le nombre de sujets en vie apres un cancer augmentent. En 2008, en France, trois millions de personnes ayant eu un cancer sont en vie et 18 millions sont prevus en 2022. La reinsertion de ces patients dans la vie « normale » souleve des problemes societaux, familiaux et professionnels. Ces trois sujets sont abordes dans ce rapport. A la fin des traitements quel que soit l’impact psychologique du cancer, le retour a la vie « normale » passe par l’acceptation d’etre gueri de la peur de mourir. Cette acceptation est d’autant plus difficile qu’une surveillance est proposee et que la prise en charge du cancer en Affection de Longue Duree (ALD) se poursuit. Les patients doivent s’investir fortement avec si necessaire un soutien psychologique et une aide de l’Association Francaise de Soins Oncologiques de Support (AFSOS), de la convention tripartite signee entre pouvoirs publics, professionnels de la banque et assureurs (AERAS) qui leur permettra de s’assurer et d’emprunter si besoin et enfin des actions en faveur du retour a l emploi. Dans tous les cas un encouragement a l activite physique et des conseils alimentaires identiques a ceux donnes en prevention primaire doivent etre formules. Le maintien d’une cohesion familiale est important et passe par le retour a une vie sexuelle normale et une proposition de preservation de la fertilite avec conservation des gametes. Chez l’enfant, avant la puberte, une proposition de conservation de tissu germinal est possible mais sa reutilisation reste du domaine de la recherche. Ce rapport est un plaidoyer pour coordonner toutes les mesures existantes garantissant au maximum de patients un retour a la « vie normale ».

Published
2018

2. A Phase I Study of Clofarabine With Multiagent Chemotherapy in Childhood High Risk Relapse of Acute Lymphoblastic Leukemia (VANDEVOL Study of the French SFCE Acute Leukemia Committee)

Author

Nelken, Brigitte, Cavé, Hélène, Leverger, Guy, Galambrun, Claire, Plat, Genevieve, Schmitt, Claudine, Thomas, Caroline, Vérité, Cecile, Brethon, Benoit, Gandemer, Virginie, Bertrand, Yves, Baruchel, André, Rohrlich, Pierre, Pôle Enfant, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université Lille Nord (France), Département de génétique [Robert Debré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'Hématologie pédiatrique, Hôpital de la Timone, Marseille, Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Service d'Hématologie Pédiatrique [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Pellegrin Tripode, Pediatric Onco-Hematology Unit, CHU Pontchaillou [Rennes], Institut de Génétique et Développement de Rennes (IGDR), Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Hématologie et immunologie pédiatrique, Hospices Civils de Lyon (HCL)-CHU Lyon-Institut d'hématologie et d'oncologie pédiatrique [CHU - HCL] (IHOPe), Hospices Civils de Lyon (HCL)-Hôpital Femme-Mère-Enfant (HFME), Service d'hématologie et immunologie pédiatrique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7), Service d'hématologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Direction de la Recherche Clinique du CHRU de Lille, Service d'hématologie-immunologie-oncologie pédiatrique [CHU Trousseau], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP Hôpital universitaire Robert-Debré [Paris], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Jean Minjoz, and Jonchère, Laurent

Subjects
Male, Salvage Therapy, Adolescent, Dose-Response Relationship, Drug, Maximum Tolerated Dose, Adenine Nucleotides, [SDV]Life Sciences [q-bio], acute lymphoblastic leukemia, phase I, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Dexamethasone, [SDV] Life Sciences [q-bio], Young Adult, resistant disease, Child, Preschool, Antineoplastic Combined Chemotherapy Protocols, Asparaginase, Humans, Female, Arabinonucleosides, Mitoxantrone, Neoplasm Recurrence, Local, Child, Clofarabine, Etoposide
Abstract

International audience; BACKGROUND: Current outcome of very early relapse of acute lymphoblastic leukemia (ALL) in children remains poor. As a single agent, clofarabine provided a response rate of 26% in childhood ALL second relapse and, in combination with cyclophosphamide and etoposide, a 44% complete remission and complete remission without platelet recovery (CR+CRp) rate. Further multi-drug combinations need to be investigated. We used the VANDA regimen as a template, cytarabine being replaced by clofarabine. PATIENTS AND METHODS: A phase I study combining escalating doses of clofarabine (25% increments from 20 to 40 mg/m(2) /d) with fixed doses of mitoxantrone, etoposide, asparaginase, and dexamethasone was undertaken in children presenting with very early or second or post-transplant ALL relapse. RESULTS: Twenty patients were enrolled, 19 were evaluable. Four patients had previously been allografted. Dose-limiting toxicity (DLT) appeared at dose level 3 (32 mg/m(2) ), one out of six patients experienced a liver DLT. At dose level 4 (40 mg/m(2) ), four DLT occurred (two fungal infection and two liver DLT). The maximum tolerated dose (MTD) of clofarabine was thus determined to be 32 mg/m(2) . There was no toxic death. Eleven (57.9%) patients achieved a CR. Six patients proceeded to allogeneic stem cell transplantation. CONCLUSION: Clofarabine MTD was 32 mg/m(2) /d in this combination which appeared feasible and effective in this population. Pediatr Blood Cancer © 2015 Wiley Periodicals, Inc

Published
2014

3. Intravenous immunoglobulin therapy for pure red cell aplasia related to human parvovirus b19 infection: a retrospective study of 10 patients and review of the literature

Author

Legendre Christophe, Yoann Crabol, Catherine Montagnier-Petrissans, Marjanovic Zora, Fischer Alain, Papo Thomas, Olivier Hermine, Le Parc Jean-Marie, Flore Rozenberg, Paré Hôpital Ambroise, Godeau Bertrand, Necker Hôpital, Montagnier-Petrissan Catherine, Mouthon Luc, Fantin Bruno, Bussel Annette, Benjamin Terrier, Hermine Olivier, Lesavre Philippe, Lortholary Olivier, Gorin Norbert-Claude, Dreyfus François, Fermand Jean-Paul, Benomar Amina, Parquet Nathalie, Christophe Legendre, Sharshar Tarek, Fontaine Bertrand, Guillevin Loïc, Charpentier Bernard, Loïc Guillevin, Sauvageon Hélène, Liou Amélie, Leverger Guy, Lopez Isabelle, Piette Jean-Charles, Bicêtre Hôpital, Luc Mouthon, Oksenhendler Eric, and Vincent Pestre

Subjects
Microbiology (medical), Adult, Male, medicine.medical_specialty, Paris, Adolescent, viruses, Pure red cell aplasia, Red-Cell Aplasia, Pure, Gastroenterology, Parvoviridae Infections, Intravenous Immunoglobulin Therapy, hemic and lymphatic diseases, Internal medicine, medicine, Parvovirus B19, Human, Humans, Aplastic anemia, Aged, Retrospective Studies, biology, business.industry, virus diseases, Immunoglobulins, Intravenous, Retrospective cohort study, Middle Aged, medicine.disease, Pulmonary edema, Surgery, Infectious Diseases, medicine.anatomical_structure, Treatment Outcome, biology.protein, Female, Hemoglobin, Bone marrow, Immunotherapy, Antibody, business
Abstract

Background. We evaluated the efficacy of intravenous immunoglobulin (IVIG) therapy in patients with pure red cell aplasia (PRCA) related to human parvovirus B19 (HPV-B19) infection. Methods. We retrospectively reviewed all HPV-B19 PRCA cases treated with IVIG between January 2000 and December 2005 in the Assistance Publique-Hopitaux de Paris hospitals and reviewed all cases of HPV-B19 PRCA cases treated with IVIG in the literature. Results. Among our 36 patients, PRCA was confirmed in 22, including 10 with proven HPV-B19 infection. Nine patients were immunocompromised, including 4 who had undergone transplant. All patients had severe anemia (mean hemoglobin level, 5.0 ± 1.9 g/dL). Seven patients who underwent bone-marrow aspiration had positive HPV-B19 polymerase chain reaction (PCR) results at diagnosis. Patients received a mean of 2.7 ± 2.1 IVIG courses (1.3 ± 0.5 g/kg/course). Hemoglobin level was corrected in 9 of the 10 patients within a mean of 80 ± 54 days. The only nonresponsive patient had underlying myelodysplasia. Blood HPV-B19 PCR results were negative from 35 to 159 days after treatment. Four patients showed side effects of IVIG treatment: acute reversible renal failure (n = 2) and pulmonary edema (n = 2). Among 133 patients with HPV-B19 PRCA who received IVIG (our 10 patients and 123 from the literature), 63 had undergone solid-organ transplant and 39 had human immunodeficiency virus infection. Hemoglobin level was corrected after the first IVIG course in 124 patients (93%); disease relapsed in 42 (33.9%), at a mean of 4.3 months. Conclusions. IVIG therapy appears to be effective in the short term in immunocompromised patients with HPV-B19 PRCA.

Published
2012

4. Molecular Profiling Defines Distinct Prognostic Subgroups in Chilhood Acute Myeloid Leukemia: A Report from the French ELAM02 Study Group

Author

Alice Marceau-Renaut, Duployez, Nicolas, Ducourneau, Benoit, Labopin, Myriam, Petit, Arnaud, Rousseau, Alexandra, Geffroy, Sandrine, Bucci, Maxime, Cuccuini, Wendy, Fenneteau, Odile, Nelken, Brigitte, Ducassou, Stephane, Gandemer, Virginie, Leblanc, Thierry, Michel, Gerard, Bertrand, Yves, Baruchel, Andre, Leverger, Guy, Preudhomme, Claude, and Lapillonne, Helene

6. Oncogenetic Risk Classification Based on NOTCH1/FBXW7/RAS/PTEN Mutation Profiles Improves Outcome Prediction in Pediatric T-Cell Acute Lymphoblastic Leukemia, Treated According the Fralle 2000 T Guidelines

Author

Petit, Arnaud, Trinquand, Amelie, Chevret, Sylvie, Ballerini, Paola Fabiola, Cayuela, Jean-Michel, Nathalie Grardel, Touzart, Aurore, Brethon, Benoit, Lapillonne, Helene, Chastagner, Pascal, Berger, Claire, Michel, Gerard, Preudhomme, Claude, Soulier, Jean, Landman-Parker, Judith, Leverger, Guy, Macintyre, Elizabeth, Baruchel, Andre, and Asnafi, Vahid

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