18 results on '"Broussais-Guillaumot F"'
Search Results
2. Prospective evaluation of supersaturated calcium phosphate oral rinse for oral mucositis after autologous and allogeneic stem cell transplantation: P1353
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Ambard, N., Brechard, C., Noyel, J. E., Gourioud, M., Michallet, A. S., Bouafia, F., Broussais-Guillaumot, F., Labussière-Wallet, H., Coiffier, B., Michallet, M., and Petiot, S.
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- 2011
3. Nodular lymphocyte predominant Hodgkin lymphoma: a Lymphoma Study Association retrospective study
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Lazarovici, J., primary, Dartigues, P., additional, Brice, P., additional, Oberic, L., additional, Gaillard, I., additional, Hunault-Berger, M., additional, Broussais-Guillaumot, F., additional, Gyan, E., additional, Bologna, S., additional, Nicolas-Virelizier, E., additional, Touati, M., additional, Casasnovas, O., additional, Delarue, R., additional, Orsini-Piocelle, F., additional, Stamatoullas, A., additional, Gabarre, J., additional, Fornecker, L.-M., additional, Gastinne, T., additional, Peyrade, F., additional, Roland, V., additional, Bachy, E., additional, Andre, M., additional, Mounier, N., additional, and Ferme, C., additional
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- 2015
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4. Contiguous follicular lymphoma and follicular lymphoma in situ harboring N-glycosylated sites
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Mamessier, E., primary, Drevet, C., additional, Broussais-Guillaumot, F., additional, Mollichella, M.-L., additional, Garciaz, S., additional, Roulland, S., additional, Benchetrit, M., additional, Nadel, B., additional, and Xerri, L., additional
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- 2014
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5. Nature and importance of follicular lymphoma precursors
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Mamessier, E., primary, Broussais-Guillaumot, F., additional, Chetaille, B., additional, Bouabdallah, R., additional, Xerri, L., additional, Jaffe, E. S., additional, and Nadel, B., additional
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- 2014
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6. Strategies for improving outcomes with 14-day anthracycline-based regimens in patients with aggressive lymphomas.
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Broussais-Guillaumot F and Coiffier B
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- 2007
7. Economic burden in non-Hodgkin lymphoma survivors: The French Lymphoma Study Association SIMONAL cross-sectional study.
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Nerich V, Guyeux C, Henry-Amar M, Couturier R, Thieblemont C, Ribrag V, Tilly H, Haioun C, Casasnovas RO, Morschhauser F, Feugier P, Sibon D, Ysebaert L, Nicolas-Virelizier E, Broussais-Guillaumot F, Damaj GL, Jais JP, Salles G, Woronoff-Lemsi M, and Mounier N
- Subjects
- Cross-Sectional Studies, Financial Stress, Health Care Costs, Humans, Retrospective Studies, Survivors, Transplantation, Autologous, Hematopoietic Stem Cell Transplantation, Lymphoma, Lymphoma, Non-Hodgkin therapy
- Abstract
Background: No study has focused on the economic burden in non-Hodgkin lymphoma (NHL) survivors, even though this knowledge is essential. This study reports on health care resource use and associated health care costs as well as related factors in a series of 1671 French long-term NHL survivors., Methods: Health care costs were measured from the payer perspective. Only direct medical costs (medical consultations, outpatient treatments, hospitalizations, and medical transport) in the past 12 months were included (reference year 2015). Multiple linear regression was used to search for explanatory factors of health care costs., Results: In total, 1100 survivors (66%) reported having used at least 1 health care resource, and 867 (52%) reported having used at least 1 outpatient treatment. After the authors accounted for missing data, the mean health care cost was estimated at €702 ± €2221. Hospitalizations and outpatient treatments were the main cost drivers. Sensitivity analyses confirmed the robustness of the results. For the 1100 survivors who reported using at least 1 health care resource, the mean health care cost was €1067 ± €2268. Several factors demonstrated statistically significant relationships with health care costs. For instance, cardiovascular disorders increased costs by 66% ± 16%. In contrast, rituximab or autologous stem cell transplantation as initial therapy had no effect on health care costs., Conclusions: The consideration of economic constraints in health care is now a reality. This retrospective study reports on a better understanding of health care resource use and associated health care costs as well as related factors. It may help health care professionals in their ongoing efforts to design person-centered health care pathways., (© 2021 American Cancer Society.)
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- 2022
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8. Long-term fatigue in survivors of non-Hodgkin lymphoma: The Lymphoma Study Association SIMONAL cross-sectional study.
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Mounier N, Anthony S, Busson R, Thieblemont C, Ribrag V, Tilly H, Haioun C, Casasnovas RO, Morschhauser F, Feugier P, Delarue R, Ysebaert L, Sebban C, Broussais-Guillaumot F, Damaj G, Nerich V, Jais JP, Laborde L, Salles G, and Henry-Amar M
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- Adolescent, Adult, Aged, Aged, 80 and over, Combined Modality Therapy, Cross-Sectional Studies, Cyclophosphamide administration & dosage, Doxorubicin administration & dosage, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prednisone administration & dosage, Prognosis, Rituximab administration & dosage, Time Factors, Transplantation, Autologous, Vincristine administration & dosage, Young Adult, Antineoplastic Combined Chemotherapy Protocols adverse effects, Cancer Survivors statistics & numerical data, Fatigue etiology, Hematopoietic Stem Cell Transplantation adverse effects, Lymphoma, Non-Hodgkin therapy, Quality of Life
- Abstract
Background: Long-term survivors of non-Hodgkin lymphoma (NHL) must cope with treatment complications and late toxicities that affect their health-related quality of life. Little is known about the risk-to-benefit ratio of new agents like rituximab. The impact of treatment regimens and health disorders on long-term fatigue levels was investigated in a cross-sectional study., Methods: Two self-administered questionnaires, the 20-item Multidimensional Fatigue Inventory (MFI-20) and a Life Situation Questionnaire, were mailed in 2015 to NHL survivors enrolled onto 12 successive clinical studies (1993-2010) conducted by the Lymphoma Study Association. Private addresses were obtained for 3317 survivors, of whom 1671 (50%) returned the questionnaires. Severe fatigue was defined as MFI-20 scores ≥60 on dimension scales scored from 0 to 100. Linear regression models were used to assess factors that were linked to increased fatigue levels., Results: The study population included 906 men and 765 women, and the median age was 64 years (age range, 24-95 years). Overall, 811 survivors had received cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP)-like chemotherapy, 518 had received high-dose CHOP, and 342 had undergone upfront autologous stem cell transplantation; 829 survivors also had received rituximab. In total, 1100 survivors (66%) reported 1 or more late health disorders. Severe fatigue was reported by 602 survivors (37%). Increased fatigue levels were associated (P < .001) with increased age, obesity, and the presence of health disorders, but not with initial treatment or rituximab., Conclusions: The survey confirms that high proportions long-term NHL survivors have severe fatigue. The results suggest that initial treatment and the receipt of rituximab have no influence on the development of long-term fatigue., (© 2019 American Cancer Society.)
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- 2019
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9. Does bendamustine impact the mobilization of peripheral blood stem cells? A multicenter retrospective study of 23 cases.
- Author
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Gac AC, Azar N, Daguindau E, Cartron G, Fornecker LM, Gyan E, Broussais-Guillaumot F, Garidi R, Choufi B, Chantepie SP, Béné MC, Guiéze R, Bijou F, Gressin R, Amorim S, and Damaj G
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- Adult, Aged, Combined Modality Therapy, Female, Humans, Lymphoma diagnosis, Male, Middle Aged, Neoplasm Staging, Retreatment, Retrospective Studies, Antineoplastic Agents, Alkylating administration & dosage, Bendamustine Hydrochloride administration & dosage, Hematopoietic Stem Cell Mobilization methods, Lymphoma therapy, Peripheral Blood Stem Cells cytology, Peripheral Blood Stem Cells drug effects
- Abstract
Bendamustine is used in the treatment of different relapsing or refractory subtypes of lymphoma. Its impact on the yield of peripheral blood stem cells is not well known. Twenty three patients who received bendamustine followed immediately or after another chemotherapy by stem cell mobilization (SCM) were included. The patients were divided into two groups: group 1 (n=17), in whom SCM was performed immediately after bendamustine chemotherapy, and group 2 (n=6), in whom SCM was performed after another cycle of chemotherapy. The success rate of mobilization after Bendamustine+/-plerixafor was 36% (eight cytapheresis succeeded for a total number of 22 cytapheresis); and 75% after other approaches (chemotherapy based or steady state) used for patients who received bendamustine previously. Although bendamustine used alone was not an effective drug to mobilize stem cells, this agent does not seem to have detrimental effects on subsequent SCM.
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- 2016
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10. Contiguous follicular lymphoma and follicular lymphoma in situ harboring N-glycosylated sites.
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Mamessier E, Drevet C, Broussais-Guillaumot F, Mollichella ML, Garciaz S, Roulland S, Benchetrit M, Nadel B, and Xerri L
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- Adult, Glycosylation, Humans, Immunoglobulin Heavy Chains chemistry, Immunoglobulin Variable Region chemistry, In Situ Hybridization, Fluorescence, Lymph Nodes metabolism, Lymph Nodes pathology, Lymphoma, Follicular metabolism, Male, Neoplasm Staging, Immunoglobulin Heavy Chains genetics, Immunoglobulin Variable Region genetics, Lymphoma, Follicular genetics, Lymphoma, Follicular pathology, Nucleotide Motifs
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- 2015
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11. Efficacy and safety of lenalinomide combined with rituximab in patients with relapsed/refractory diffuse large B-cell lymphoma.
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Ivanov V, Coso D, Chetaille B, Esterni B, Olive D, Aurran-Schleinitz T, Schiano JM, Stoppa AM, Broussais-Guillaumot F, Blaise D, and Bouabdallah R
- Subjects
- Aged, Antibodies, Monoclonal, Murine-Derived administration & dosage, Antibodies, Monoclonal, Murine-Derived adverse effects, Antineoplastic Combined Chemotherapy Protocols adverse effects, Disease-Free Survival, Drug Resistance, Neoplasm, Fatigue chemically induced, Female, Humans, Lenalidomide, Lymphoma, Large B-Cell, Diffuse pathology, Male, Middle Aged, Neoplasm Recurrence, Local, Neutropenia chemically induced, Remission Induction, Retrospective Studies, Rituximab, Thalidomide administration & dosage, Thalidomide adverse effects, Thalidomide analogs & derivatives, Thrombocytopenia chemically induced, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Lymphoma, Large B-Cell, Diffuse drug therapy
- Abstract
Initial clinical trials demonstrated that lenalidomide monotherapy has a significant activity against some subtypes of lymphoma, but in diffuse large B-cell lymphoma (DLBCL) its activity is limited. The combination of lenalidomide with rituximab may be a promising therapeutic strategy. We retrospectively analyzed clinical outcomes in 17 patients with relapsed/refractory (R/R) DLBCL treated with lenalidomide, 25 mg/day for 21/28 days and rituximab, 375 mg/m(2) on day 7 of every lenalidomide cycle, for a maximum of 12 months. The overall response rate (ORR) was 41.2% with 35.3% complete response (CR), while median response duration was 26.5 months at a median follow-up of 24.9 months. Two patients with CR relapsed after 4 and 27 months of CR, and another four are actually in CR at + 13, + 23, + 24 and + 29 months. The estimated 24-month overall survival (OS) was 45% and progression-free survival (PFS) was 38%. Adverse events were manageable and mostly included thrombocytopenia and neutropenia. Lenalidomide-rituximab is active in R/R DLBCL with an important percentage of continuous CR.
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- 2014
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12. Large B-cell lymphomas in adolescents and young adults in comparison to adult patients: a matched-control analysis in 55 patients.
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Coso D, Garciaz S, Esterni B, Broussais-Guillaumot F, Ivanov V, Aurran-Schleinitz T, Schiano JM, Stoppa AM, Chetaille B, Blaise D, Vey N, and Bouabdallah R
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- Adolescent, Adult, Age Factors, Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Case-Control Studies, Female, Humans, Lymphoma, Large B-Cell, Diffuse mortality, Male, Middle Aged, Neoplasm Staging, Prognosis, Treatment Outcome, Young Adult, Lymphoma, Large B-Cell, Diffuse diagnosis, Lymphoma, Large B-Cell, Diffuse therapy
- Abstract
The aim of our study was to assess whether large B-cell lymphoma (LBCL) in adolescents and young adults (AYA) should be considered as a clinocopathological entity, and to evaluate the prognostic value of age. Fifty-five patients aged > 15-30 years were fully matched to 365 adult patients aged 31-65 years. We found a high incidence of primary mediastinal thymic LBCL subtype (33% vs. 5%), while histological transformation was rare (2% vs. 14%). LBCL in AYA presented with a bulky mediastinal mass (51% vs. 21%), and the lactate dehydrogenase (LDH) value was significantly higher (73% vs. 54%). The complete response rate to chemotherapy was similar in the two groups. Five-year overall survival (OS) and event-free survival (EFS) of AYA were 73% and 68%, respectively. The matched-control analysis showed no difference for either OS or EFS. LBCL in AYA presents with some critical features which differ from those of older adults. However, the outcome is equivalent to that observed in older patients.
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- 2014
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13. Antithymocyte globulin in reduced-intensity conditioning regimen allows a high disease-free survival exempt of long-term chronic graft-versus-host disease.
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Devillier R, Fürst S, El-Cheikh J, Castagna L, Harbi S, Granata A, Crocchiolo R, Oudin C, Mohty B, Bouabdallah R, Chabannon C, Stoppa AM, Charbonnier A, Broussais-Guillaumot F, Calmels B, Lemarie C, Rey J, Vey N, and Blaise D
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- Adult, Aged, Busulfan therapeutic use, Chronic Disease, Female, Graft vs Host Disease immunology, Hematologic Neoplasms immunology, Hematologic Neoplasms mortality, Hematologic Neoplasms pathology, Humans, Male, Middle Aged, Prospective Studies, Survival Analysis, Transplantation, Homologous, Treatment Outcome, Vidarabine analogs & derivatives, Vidarabine therapeutic use, Antilymphocyte Serum therapeutic use, Antineoplastic Agents therapeutic use, Graft vs Host Disease pathology, Hematologic Neoplasms therapy, Hematopoietic Stem Cell Transplantation, Transplantation Conditioning methods
- Abstract
Nonmyeloablative (NMA) regimens allow the use of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients considered unfit for standard myeloablative conditioning (MAC) regimens using high-dose alkylating agents with or without total body irradiation (TBI). Reduced-intensity conditioning (RIC) regimens, based on fludarabine (Flu), busulfan (Bu), and rabbit antithymocyte globulin (r-ATG), represent an intermediate alternative between NMA and MAC regimens. This platform was subsequently optimized by the introduction of i.v. Bu and the use of 5 mg/kg r-ATG, based on the hypothesis that these modifications would improve the safety of RIC allo-HSCT. Here we report a study conducted at our institution on 206 patients, median age 59 years, who underwent allo-HSCT after conditioning with Flu, 2 days of i.v. Bu, and 5 mg/kg r-ATG (FBx-ATG) between 2005 and 2012. The prevalence of grade III-IV acute graft-versus-host disease (GVHD) was 9%, and that of extensive chronic GVHD was 22%. Four-year nonrelapse mortality (NRM), relapse, and overall survival (OS) rates were 22%, 36%, and 54%, respectively. NRM tended to be influenced by comorbidities (hematopoietic cell transplantation-specific comorbidity index [HCT-CI] <3 versus HCT-CI ≥3: 18% versus 27%; P = .075), but not by age (<60 years, 20% versus ≥60 years, 25%; P = .142). Disease risk significantly influenced relapse (2 years: low, 8%, intermediate, 28%, high, 34%; very high, 63%; P = .017). Both disease risk (hazard ratio [95% confidence interval]: intermediate, 2.1 [0.8 to 5.2], P = .127; high, 3.4 [1.3 to 9.1], P = .013; very high, 4.0 [1.1 to 14], P = .029) and HCT-CI (hazard ratio [95% confidence interval]: HCT-CI ≥3, 1.7 (1.1 to 2.8), P = .018) influenced OS, but age and donor type did not. The FBx-ATG RIC regimen reported here is associated with low mortality and high long-term disease-free survival without persistent GVHD in both young and old patients. It represents a valuable platform for developing further post-transplantation strategies aimed at reducing the incidence of relapse, particularly in the setting of high-risk disease., (Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
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- 2014
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14. Peripheral T-cell lymphomas: analysis of histology, staging and response to treatment of 208 cases at a single institution.
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Broussais-Guillaumot F, Coso D, Belmecheri N, Ivanov V, Schiano de Collela JM, Aurran-Schleinitz T, Stoppa AM, Chetaille B, Xerri L, Esterni B, Blaise D, and Bouabdallah R
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- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Female, Hematopoietic Stem Cell Transplantation, Humans, Lymphoma, T-Cell, Peripheral mortality, Male, Middle Aged, Neoplasm Staging, Prognosis, Retrospective Studies, Transplantation, Autologous, Treatment Outcome, Young Adult, Lymphoma, T-Cell, Peripheral diagnosis, Lymphoma, T-Cell, Peripheral therapy
- Abstract
Peripheral T-cell lymphomas are characterized by a poor clinical outcome. We retrospectively analyzed 208 adults treated in our institution between 2000 and 2011. Median age at diagnosis was 55 years. Fifty-one percent had B symptoms and 51% serum elevated lactate dehydrogenase (LDH) levels. Eastern Cooperative Oncology Group (ECOG) performance status (PS) was 0-1 in 63% and 2-4 in 37%. According to Ann Arbor classification, 16% were at stage I-II and 84% at stage III-IV. Histological subtypes were: 39% peripheral T-cell non-Hodgkin lymphoma (NHL) unspecified (PTCL-U), 19.5% anaplastic large cell lymphoma (ALCL), with 9.5% ALK+ and 10% ALK-, and 25% angioimmunoblastic lymphoma (AILT). Primary extranodal lymphoma represented 17%, and 8% were diagnosed with hemophagocytosis. Induction chemotherapy was CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) in 87% of patients. The median number of chemotherapy cycles was 2 (1-7). A complete response was obtained in 57% of the patients. Among them, 32% had an autologous stem cell transplant (ASCT) and 10% allogeneic SCT, while 38% were primary refractory. Five-year overall survival (OS) was 28.5% (22.3-36.3), and 5-year event-free survival (EFS) was 18.4% (13.4-25.3). A multivariate analysis showed that ALCL-ALK+ (p = 0.004), AILT (p < 0.01), extranodal involvement (p = 0.001), PS > 1 (p = 0.04), LDH < normal (p = 0.003) and hemophagocytosis (p = 0.001) were independent adverse factors for OS. We conclude that conventional chemotherapy with intensive treatment is not sufficient to improve the response rate. Optimal management is required.
- Published
- 2013
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15. Pretreatment levels of vascular endothelial growth factor in plasma predict a complete remission rate and time to relapse or progression in patients with diffuse large B-cell lymphoma.
- Author
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Lech-Maranda E, Bienvenu J, Broussais-Guillaumot F, Michallet AS, Warzocha K, Biliński P, Boyle P, Coiffier B, and Salles G
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- Anthracyclines therapeutic use, B-Lymphocytes pathology, Disease Progression, Disease-Free Survival, Female, Humans, Lymphoma, Large B-Cell, Diffuse drug therapy, Lymphoma, Large B-Cell, Diffuse mortality, Male, Middle Aged, Predictive Value of Tests, Prognosis, Recurrence, Remission Induction, B-Lymphocytes drug effects, Biomarkers, Pharmacological blood, Lymphoma, Large B-Cell, Diffuse diagnosis, Vascular Endothelial Growth Factor A blood
- Abstract
The aim of this study was to verify whether pretreatment plasma levels of vascular endothelial growth factor (VEGF) correlate with prognosis and survival of patients with diffuse large B-cell lymphoma (DLBCL). Plasma VEGF levels were assessed at the time of diagnosis in 157 DLBCL patients treated with anthracycline-based chemotherapy. Plasma VEGF levels greater than or equal to the highest quartile (high VEGF levels) were associated with lower probability of a complete remission achievement (odds ratio 0.3; 95% confidence interval [CI]: 0.1-0.6; p = 0.002) in univariate as well as in multivariate analysis (p = 0.04). The estimated 3-year progression-free survival (PFS) rate of patients with high VEGF levels was 31.7% (95% CI 17-51) compared to the 62.5% 3-year PFS rate (95% CI 53-71; p = 0.0004) in the patients with lower values. The former group of patients demonstrated an estimated 3-year overall survival (OS) rate of 47.1% (95% CI 30-65) in contrast to the 3-year OS rate of 64.3% (95% CI 54-73; p = 0.02) in the latter. In multivariate analysis, the high VEGF level retained its independent impact on shorter PFS (p = 0.02). Our results suggest that VEGF plays an important role in the clinical course of DLBCL. VEGF may be a useful marker for selecting the patients for whom new treatment approaches, especially those based on VEGF inhibitors, could be recommended.
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- 2013
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16. Lymphoma recurrence 5 years or later following diffuse large B-cell lymphoma: clinical characteristics and outcome.
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Larouche JF, Berger F, Chassagne-Clément C, Ffrench M, Callet-Bauchu E, Sebban C, Ghesquières H, Broussais-Guillaumot F, Salles G, and Coiffier B
- Subjects
- Adult, Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Biopsy, Disease-Free Survival, Female, France, Humans, Immunohistochemistry, Kaplan-Meier Estimate, Lymphoma, Large B-Cell, Diffuse mortality, Lymphoma, Large B-Cell, Diffuse therapy, Male, Middle Aged, Neoplasm Staging, Phenotype, Radiotherapy, Adjuvant, Recurrence, Retrospective Studies, Salvage Therapy, Stem Cell Transplantation, Time Factors, Transplantation, Autologous, Treatment Outcome, Lymphoma, Large B-Cell, Diffuse pathology
- Abstract
PURPOSE Patients with diffuse large B-cell lymphoma (DLBCL) usually relapse early following diagnosis but some relapses happen at 5 years or later. Few data exist regarding clinical characteristics and outcome of these patients. PATIENTS AND METHODS We performed a retrospective analysis of all patients from two centers in Lyon, France, between 1985 and 2003 who had a biopsy-proven relapse 5 years or later following diagnosis of DLBCL. All available biopsies were reviewed and immunohistochemistry was completed. Results Among 1,492 patients with DLBCL, 54 were eligible. At diagnosis, 63% of patients had stage I-II, 82% had low/low-intermediate International Prognostic Index (IPI) score, 65% had extranodal involvement, 24% had an indolent component associated with DLBCL, 57% had germinal center phenotype, and 43% had non-germinal center phenotype. Median time from diagnosis to relapse was 7.4 years (range, 5 to 20.5 years). At time of relapse, 83% had DLBCL histology, and 17% had indolent histology. Having an indolent component at diagnosis was associated with indolent histology at relapse (P = .028). Five-year event free-survival (EFS) was 17% for patients with DLBCL relapse and 61% for patients with indolent relapse (P = .027). Five-year overall survival was 27% for patients with DLBCL and 75% for patients with indolent relapse (P = .029). For DLBCL relapse, 3-year EFS was 56% versus 18% with autologous stem-cell transplantation or not, respectively (P = .0661). CONCLUSION Patients with DLBCL who had a late relapse usually had localized stage, favorable IPI score, and extranodal involvement at diagnosis. The outcome of patients with DLBCL at time of relapse remains poor, and aggressive treatment such as autologous stem-cell transplantation should be pursued whenever possible. Biopsy at relapse is essential because some patients relapse with indolent histology.
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- 2010
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17. Plasma TNF-alpha and IL-10 level-based prognostic model predicts outcome of patients with diffuse large B-Cell lymphoma in different risk groups defined by the International Prognostic Index.
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Lech-Maranda E, Bienvenu J, Broussais-Guillaumot F, Warzocha K, Michallet AS, Robak T, Coiffier B, and Salles G
- Subjects
- Biomarkers blood, Chi-Square Distribution, Cyclophosphamide administration & dosage, Disease-Free Survival, Doxorubicin administration & dosage, Female, Humans, Kaplan-Meier Estimate, Lymphoma, Large B-Cell, Diffuse diagnosis, Lymphoma, Large B-Cell, Diffuse mortality, Male, Middle Aged, Neoplasm Staging, Odds Ratio, Predictive Value of Tests, Prednisone administration & dosage, Proportional Hazards Models, Prospective Studies, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Up-Regulation, Vincristine administration & dosage, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Interleukin-10 blood, Lymphoma, Large B-Cell, Diffuse drug therapy, Lymphoma, Large B-Cell, Diffuse immunology, Tumor Necrosis Factor-alpha blood
- Abstract
Tumor necrosis factor (TNF)-alpha and interleukin (IL)-10 are key cytokines involved in lymphoma development. Their pretreatment plasma levels were reported to influence the clinical course of non-Hodgkin's lymphoma. In this study the impact of combined elevation of TNF-alpha and IL-10 on disease features and outcome of patients with diffuse large B-cell lymphoma (DLBCL) were investigated. Plasma TNF-alpha and IL-10 levels were determined at the time of diagnosis in a group of 106 DLBCL patients uniformly treated with anthracycline-based regimens. Three risk groups depending on the pretreatment levels of the cytokines were identified: low-, intermediate-, and high-risk groups. In univariate analysis, the cytokine intermediate- and high-risk groups were associated with lower probability of achieving a complete remission (odds ratio [OR] = 0.2, 95% confidence interval [CI] 0.06-0.6, p = 0.006 and OR = 0.05, 95% CI 0.01-0.2, p < 0.0001, respectively) and shorter progression-free survival (PFS) (OR = 4.4, 95% CI 1.9-10.2, p < 0.001 and OR = 9.7, 95% CI 4.1-23.0, p < 0.0001, respectively) and overall survival (OS) (OR = 4.2, 95% CI 1.7-10.1, p = 0.002 and OR = 11.2, 95% CI 4.4-28.4, p < 0.0001, respectively) in comparison with the cytokine low-risk group. In multivariate analysis, the cytokine intermediate- and high-risk groups also correlated with shorter PFS (relative risk [RR] = 4.5, 95% CI 1.9-10.9, p = 0.001 and RR = 5.8, 95% CI 2.2-15.3, p < 0.0001, respectively) and OS (RR = 4.6, 95% CI 1.8-12.0, p = 0.001 and RR = 7.5, 95% CI 2.7-20.9, p < 0.0001, respectively) regardless of the International Prognostic Index (IPI) scoring system. The TNF-alpha and IL-10 level-based index may work as an additional model to the IPI for predicting the survival of DLBCL patients. This model may help to identify patients in a given IPI risk group for whom more accurate and risk-adapted treatment could be advised.
- Published
- 2010
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18. Retreatment with rituximab in 178 patients with relapsed and refractory B-cell lymphomas: a single institution case control study.
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Johnston A, Bouafia-Sauvy F, Broussais-Guillaumot F, Michallet AS, Traullé C, Salles G, and Coiffier B
- Subjects
- Adult, Aged, Aged, 80 and over, Antibodies, Monoclonal, Murine-Derived, Case-Control Studies, Disease Progression, Disease-Free Survival, Female, Humans, Lymphoma, B-Cell pathology, Lymphoma, Follicular drug therapy, Lymphoma, Follicular pathology, Male, Middle Aged, Recurrence, Rituximab, Treatment Outcome, Antibodies, Monoclonal therapeutic use, Lymphoma, B-Cell drug therapy
- Abstract
The role of rituximab retreatment in relapsed B-cell lymphoma is not well known. We undertook a single center retrospective cohort study to investigate the efficacy of retreatment with rituximab with or without chemotherapy in patients with relapsed and refractory B-cell lymphomas. We only included patients treated first-line and in first progression; 178 patients were included in the study, of whom 29% had diffuse large B-cell lymphoma (DLBCL) and 28% had follicular lymphoma (FL). The overall response rate for the first treatment was 81% and for the second treatment was 66%. The median progression-free survival (PFS) for all patients from diagnosis was 13.2 months and from relapse was 12.5 months (not statistically different). For DLBCL the median PFS from diagnosis was 9.6 months and from relapse was 8.4 months, and for FL the median PFS from diagnosis was 26.4 months and from relapse was 19.2 months (not statistically different). The 5-year overall survival was 57%. In a historical comparison with rituximab-naive patients, rituximab-retreated patients had a shorter time to initial relapse than control patients, but there was no difference between the two groups for PFS from relapse. In conclusion, retreatment with rituximab, with or without chemotherapy, yields a high overall response rate in patients with relapsed and refractory B-cell lymphomas. Relapse occurring after rituximab-containing therapy appears to be more aggressive than that occurring after chemotherapy alone. The outcome of retreatment, in terms of progression-free survival, is similar to that of primary treatment.
- Published
- 2010
- Full Text
- View/download PDF
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