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Ianotto J.-C.,Institute Of Cancero Hematologie | Boyer-Perrard F.,Angers University Hospital Center | Gyan E.,CNRS Genetics, Immunotherapy, Chemistry & Cancer Laboratory | Laribi K.,Service dhematologie | And 16 more authors.
British Journal of Haematology | Year: 2013

Myeloproliferative neoplasm-related myelofibrosis is associated with cytopenic or proliferative phases, splenomegaly and constitutional symptoms. Few effective treatments are available and small series suggested that interferon could be an option for myelofibrosis therapy. We performed a retrospective study of pegylated-interferon α-2a (Peg-IFNα-2a) therapy in myelofibrosis. Sixty-two patients treated with Peg-IFNα-2a at 17 French and Belgian centres were included. Responses were determined based on the criteria established by the International Working Group for Myelofibrosis Research and Treatment. Mean follow-up was 26 months. Sixteen of 25 anaemic patients (64%) (eight concomitantly receiving recombinant erythropoietin) achieved a complete response and transfusion-independence was obtained in 5/13 patients (38·5%). Constitutional symptoms resolved in 82% of patients. All five leucopenic patients normalized their leucocyte counts, whereas a normal platelet count was obtained in 5/8 thrombocytopenic patients. Splenomegaly was reduced in 46·5% of patients, and complete resolution of thrombocytosis and leucocytosis were observed in 82·8% and 68·8% of patients, respectively. Side effects (mostly haematological) were mainly of grade 1-2. The only factor independently associated with treatment failure was a spleen enlargement of more than 6 cm below the costal margin. In conclusion, Peg-IFNα-2a induced high response rates with acceptable toxicity in a large proportion of patients with primary and secondary myelofibrosis, especially in early phases. © 2013 John Wiley & Sons Ltd.

Le Calloch R.,Institute Of Cancero Hematologie | Voldoire M.,Nantes University Hospital Center | Le Gouill S.,Nantes University Hospital Center
Hematologie | Year: 2015

Mantle cell lymphoma (MCL) is a rare and agressive form of non Hodgkin's lymphoma with one of the worst outcomes. The last decades have established a standard treatment based on the use of cytarabine combined with rituximab followed by a therapeutic intensification and autologous transplantation in young patients. Despite this, LCM remains an aggressive entity with many relapses. Currently, a new era is emerging with the development of new targeted therapies that are coming to change our attitudes and therefore the prognosis of this disease. This review presents the current standard treatment and therapeutic developments in MCL.

de Guibert S.,University of Rennes 2 - Upper Brittany | de Latour R.P.,Hematologie Greffe | Varoqueaux N.,Alexion Pharma | Labussiere H.,Hematologie Clinique | And 11 more authors.
Haematologica | Year: 2011

Background: Pregnancy in women with paroxysmal nocturnal hemoglobinuria is rare, with few reports on maternal and fetal mortality rates. Design and Methods: A specific questionnaire designed to solicit data on pregnancies in women with paroxysmal nocturnal hemoglobinuria was sent to all members of the French Society of Hematology in January 2008. Results: We identified 27 pregnancies in 22 women at 10 French Society of Hematology centers between 1978 and 2008. The median age was 21.5 years at diagnosis of paroxysmal nocturnal hemoglobinuria and 27 years at pregnancy. None of these women had received eculizumab during their pregnancy. Maternal complications, consisting mostly of cytopenias requiring transfusions, occurred in 95% of cases. Two cases of severe aplastic anemia (de novo in one case and relapse in the other) were recorded. No thrombotic events occurred during pregnancy, whereas 4 postpartum thromboses (16%) were recorded, 2 of which were fatal (maternal mortality rate 8%). Most patients received antithrombotic prophylaxis during pregnancy and postpartum (n=16; 64%). Delivery was preterm in 29% of cases, and birth weight was less than 3 kg in 53% of cases. Fetal mortality rate was 4%. Conclusions: Pregnancy during paroxysmal nocturnal hemoglobinuria is associated with increased maternal and fetal mortality rates (8% and 4%, respectively, in this series). Maternal mortality is related to postpartum thromboses. Prophylactic anticoagulation is recommended during pregnancy and for six weeks postpartum. © 2011 Ferrata Storti Foundation.

Ianotto J.-C.,Institute Of Cancero Hematologie | Tempescul A.,Institute Of Cancero Hematologie | Eveillard J.-R.,Institute Of Cancero Hematologie | Andre N.,Departement de Pneumologie | And 3 more authors.
Journal of Hematology and Oncology | Year: 2010

Background: Mantle cell lymphoma is a lymphoid entity characterized by adenopathy, blood and bone marrow involment which only recurrent mucosal localisation is the lymphomatoid polyposis. Few other mucosal infiltrations have been already reported. Results: We report here the first case of a unique tracheal localisation of mantle cell lymphoma at presentation of the disease. The presence of classical t(11;14)(q13;q32) confirmed the diagnosis of mantle cell lymphoma by eliminating MALT or cancer localisation. Conclusion: This case illustrates the necessity to ensure the diagnosis of mucosal lymphoma versus MCL since these diseases need different treatment regimens and prognoses. © 2010 Ianotto et al; licensee BioMed Central Ltd.

Ianotto J.-C.,Institute Of Cancero Hematologie | Ngo Sack F.,Institute Of Cancero Hematologie | Couturier M.-A.,Institute Of Cancero Hematologie | Tempescul A.,Institute Of Cancero Hematologie | And 4 more authors.
Leukemia and Lymphoma | Year: 2014

Granulocyte-colony stimulating factors (G-CSFs) enhance bone marrow (BM) recovery after autologous stem cell transplant (ASCT) in patients with lymphoma and myeloma. Few publications exist that discuss the use of filgrastim biosimilars after ASCT. We conducted a single-center retrospective study in patients with lymphoma and myeloma treated at Brest Hospital to assess the cost reductions related to and the efficiency and safety of filgrastim biosimilars. We identified 65 patients with lymphoma or myeloma treated with filgrastim biosimilars for ASCT and compared 19 parameters of these patients, including BM recovery, side effects, infectious complications and treatment costs, with published historical data on a cohort of 50 patients treated with classic filgrastim. We observed a significant reduction of G-CSF costs in both groups but did not observe a change in total hospitalization costs (representing less than 2% of the costs) between groups. Additionally, we did not observe differences between the two groups in BM recovery, infectious complications, side effects or the other studied parameters. In this retrospective study, the absence of differences between groups after ASCT in lymphoma and myeloma led us to believe that these drugs could be safely and effectively used for such indications without a significant impact on hospitalization costs. A prospective study should be conducted to confirm our results. © 2013 Informa UK, Ltd.

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