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Sainte-Foy-lès-Lyon, France

Pickering M.-E.,Hopital E Herriot | Chapurlat R.,Hopital E Herriot | Chapurlat R.,French Institute of Health and Medical Research | Chapurlat R.,University of Lyon | And 3 more authors.
Pain Practice | Year: 2016

Sleep disturbances are particularly troublesome in patients with painful rheumatic disease. This article reviews the literature specifically published on sleep disturbances in osteoarthritis, a prevalent pathology and leading cause of disability. Several aspects of the relationship between sleep and osteoarthritis are discussed, including epidemiology, pathophysiological hypotheses, and treatment outcomes. Sleep is of central importance in the well-being of patients and should systematically be assessed in patients with osteoarthritis. When needed, a specific treatment of sleep disorders should be associated with an optimal management of pain to achieve synergistic improvements in quality of life. More large-scale studies are needed to identify predictive factors of sleep impairment in osteoarthritis. © 2016 World Institute of Pain. Source


Mallet Y.,Center Oscar Lambret | Moriniere S.,Hopital Bretonneau | Ceruse P.,Hopital Lyon Sud | El Bedoui S.,Center Oscar Lambret
Bulletin du Cancer | Year: 2010

Robotic assisted surgery is a new field of developing program for many specialities. As to head and neck oncology, the new procedure potentially offers alternatives to conventional surgery with decreased morbidity. The aim of this article is a description of the state of the art via a review of the literature. We emphasize limits and future prospects on this topic with a special focus on dependability. Transoral robotic surgery (TORS) is a promising surgical procedure contingent on the development of new associated functions like an image guidance system or a force feedback control. The good developing of this new tool will also depend on the quality of clinical works and research programs. ©John Libbey Eurotext. Source


Deau B.,University of Paris Descartes | Bachy E.,Hopital Lyon Sud | Ribrag V.,Institute Gustave Roussy | Delarue R.,University of Paris Descartes | And 5 more authors.
Leukemia and Lymphoma | Year: 2013

Tumor-associated macrophages (TAMs) might be associated with worse outcome in classical Hodgkin lymphoma (cHL). Our aim was to determine whether TAMs correlated with refractoriness in cHL. In a cohort of 18 consecutive primary refractory or early relapsed cases and 41 randomly selected controls (responder patients), high TAM infiltration was significantly associated with refractoriness or early relapse (p = 0.004) and remained independently correlated with outcome in multivariate analysis (odds ratio 8.276, 95% confidence interval 1.214-56.408). This study provides evidence that the marker CD68 might accurately predict early outcome of de novo cHL and could be used in combination with c-kit and TiA1 staining. © 2013 Informa UK, Ltd. Source


Mariette X.,University Paris - Sud | Rouanet S.,Roche Holding AG | Sibilia J.,Hopitaux Universitaires Of Strasbourg | Combe B.,Montpellier University | And 4 more authors.
Annals of the Rheumatic Diseases | Year: 2014

Background The licensed dose of rituximab in rheumatoid arthritis (RA) is two doses of 1000 mg given 2 weeks apart. A lower dose has never been specifically studied in patients with an inadequate response to anti-tumour necrosis factor (TNF) agents. Objective To compare the efficacy and safety of rituximab repeat treatment with two doses (1000 mg×1 and 1000 mg×2) following initial treatment with 1000 mg×2. Methods We set up an open-label, prospective, multicentre, non-inferiority study comprising a noncontrolled period (24 weeks) followed by a randomised controlled period (weeks 24-104) in patients with RA and an inadequate response to anti-TNF agents. All patients received one course of rituximab (1000 mg×2) with methotrexate. At week 24, patients achieving a EULAR response (moderate or good) were randomised to rituximab retreatment at 1000 mg×1 (Arm A) or 1000 mg×2 (Arm B). The primary objective measure was disease activity in 28 joints C-reactive protein (DAS28-CRP) area under the curve (AUC) over 104 weeks with a non-inferiority margin defined by 20% (444) of the mean DAS28-CRP AUC (mean±SD 2218±967) of the reference data. Results The intent-to-treat and per-protocol (PP) populations comprised 143 (A/B: 70/73) and 100 (A/B: 51/49) patients, respectively. The adjusted mean difference in DAS28-CRP AUC (PP) was 51.4 (95% CI -131.2 to 234), demonstrating non-inferiority between arms A and B. The overall rituximab safety profile was similar with both retreatment regimens. Conclusions Following a clinical response to a first course of rituximab in RA at the licensed dose of 1000 mg×2, retreatment with rituximab at 1000 mg×1 results in efficacy outcomes that are non-inferior to those achieved with retreatment at 1000 mg×2. Source


Tanguy-Schmidt A.,French Institute of Health and Medical Research | Chalandon Y.,University of Geneva | Cayuela J.-M.,University Paris Diderot | Hayette S.,University of Lyon | And 8 more authors.
Biology of Blood and Marrow Transplantation | Year: 2013

We report here the results of the GRAAPH-2003 trial with long-term follow-up in 45 patients with de novo Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). Imatinib-based strategy improved the 4-year overall survival (OS) up to 52% versus 20% in the pre-imatinib LALA-94 trial (P = .0001). Despite the selection in patients who actually underwent transplantation, these results suggest that allogeneic or autologous stem cell transplants (SCTs) still have a place in overcoming the poor prognosis of Ph+ ALL in the era of imatinib therapy. OS was 50% after allogeneic SCT (24 patients), 33% in patients without a transplantation (9 patients), and 80% after autologous SCT (10 patients without allogeneic donor or >55 years, including 7 patients in complete molecular response). © 2013 American Society for Blood and Marrow Transplantation. Source

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