Institute Bordet

Brussels, Belgium

Institute Bordet

Brussels, Belgium
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Vafa H.,Oncology and Hepatology | Arvanitakis M.,Oncology and Hepatology | Demetter P.,Free University of Colombia | Eisendrath P.,Oncology and Hepatology | And 4 more authors.
Journal of the Pancreas | Year: 2013

Context Pancreatic/para-pancreatic tuberculosis is an extremely rare clinical entity even in endemic regions. It can present as a cystic or solid pancreatic mass mimicking pancreatic malignancy. There are no specific imaging criteria and the clinical symptoms remain vague. Therefore, most cases are diagnosed after surgical exploration for presumed pancreatic neoplasia. Case report We report five cases of pancreatic tuberculosis each time with a different clinical presentation, in an occidental country setting where the diagnosis was done by EUS guided FNA (EUS-FNA). Conclusion EUS-FNA is a safe and promising technique for the diagnosis of pancreatic/para-pancreatic tuberculosis, avoiding unnecessary surgery.

Caers J.,University of Liège | Vekemans M.-C.,Cliniques Universitaires Saint Luc | Bries G.,AZ Turnhout | Beel K.,ZNA Middelheim | And 16 more authors.
Annals of Medicine | Year: 2013

The prevalence of monoclonal gammopathy of undetermined significance (MGUS) is generally estimated at 3.4% in the general population over 50 years, and its incidence increases with age. MGUS represents a preneoplastic entity that can transform into multiple myeloma or other lymphoproliferative disorders. The risk of malignant transformation is estimated at 1% per year and persists over time. Predictors of malignant transformation have been identified such as the heavy chain isotype, The level of monoclonal proteins, increasing levels of the monoclonal component during the first years off follow-up, the percentage of bone marrow plasmocytosis, the dosage of serum free light chains, the presence of immunophenotypically abnormal plasma cells, aneuploidy, and the presence of circulating plasma cells. Prognostic scores that combine certain of these factors have been proposed and allow the identification of high-risk patients. Their use could assist in tailoring the care for each patient, based on his/her risk profile. © 2013 Informa UK, Ltd.

Remmelink M.,Free University of Colombia | de Leval L.,University of Liège | Decaestecker C.,Institute of Pharmacy | Duray A.,University of Mons | And 6 more authors.
Histopathology | Year: 2011

Aims: This study tests the hypothesis that histopathological fingerprinting of galectins, which are emerging multifunctional effectors in cell sociology, could refine the differential diagnosis of salivary tumours. Methods and results: We applied non-crossreactive polyclonal antibodies against galectin-1 (Gal-1), galectin-3 (Gal-3), galectin-7 (Gal-7) and galectin-8 (Gal-8) for immunohistochemical analysis of salivary gland tumours (72 cases with benign disease and 39 cases with malignancy) and 29 control specimens. The principal positivity of cases, the site of signal presence and the quantitative parameters concerning percentage of positive cells and labelling intensity were determined. Acinic cell and adenoid cystic carcinomas (specifically tubular and cribriform types) shared the expression signature of Gal-1, Gal-3 and Gal-8 presence combined with Gal-7 absence. Mucoepidermoid carcinomas presented a unique profile based on cytoplasmic Gal-1, Gal-3, Gal-7 and Gal-8 localization in the intermediate cells. Adenomas were separable from malignancy by a consistent decrease in the labelling index (LI) for Gal-7 and Gal-8 (LI Gal-7, P<10 -6; LI Gal-8, P=0.001). When present, staining for the tumour suppressor p16 INK4a coincided with Gal-1 presence. Conclusions: Expression profiling of the four tested galectins in salivary gland tumours revealed non-uniform staining patterns with discriminatory potential based on intracellular localization and quantitative aspects. © 2011 Blackwell Publishing Limited.

Heimann P.,Free University of Colombia | Lambert F.,University of Liège | Bron D.,Institute Bordet | Cottin V.,Louis Pradel Hospital | Cordier J.-F.,Louis Pradel Hospital
Respiration | Year: 2016

Chronic eosinophilic leukaemia associated with the FIP1L1-PDGFRA fusion gene (F/P+ CEL) is a rare cause of marked persistent hypereosinophilia, arising almost exclusively in male patients. Clinical presentations are heterogeneous with a higher incidence of eosinophil-mediated cardiomyopathy than in other hypereosinophilic syndrome variants. Features of chronic myeloproliferative disease are often present, including splenomegaly and elevated serum Vitamin B12 levels. The diagnosis is made by fluorescence in situ hybridization (FISH) showing the deletion of the CHIC2 locus and/or RT-PCR showing the FIP1L1-PDGFRA fusion transcript. Treatment with imatinib mesylate, a tyrosine kinase inhibitor, results in rapid and complete resolution of hypereosinophilia and associated symptoms, except for those related to sub-endocardial fibrosis that may be irreversible. We report the case of a male patient in whom isolated intractable cough remained the only clinical manifestation of F/P+ CEL for 4 years. Furthermore, eosinophil autofluorescence, an as yet unreported artefact in this setting, precluded the detection of the CHIC2 deletion and further delayed diagnosis, underlining that both FISH and RT-PCR should be performed when this disease is suspected. © 2016 S. Karger AG, Basel.

Selleslag D.,AZ Sint Jan Bruges Oostende | Dierickx D.,University Hospitals Leuven | Breems D.A.,Ziekenhuis Netwerk Antwerpen Stuivenberg | Huynh P.,Institute Bordet | And 4 more authors.
Acta Clinica Belgica | Year: 2011

Introduction: Currently available stem cell mobilizing regimens (G-CSF +/- chemotherapy) show high failure rates, especially in heavily pretreated patients. Plerixafor, a new stem cell mobilizing agent blocking the CXCR4-SDF-1 interaction, offers a new strategy for stem cell mobilization, especially in poor mobilizers. This study reports on the outcome of the Belgian compassionate use program (CUP). Materials and methods: Between July 2008 and July 2009, 14 Belgian transplant centres participated in plerixafor CUP. In total, 22 poor stem cell mobilizers were included. Patients who previously failed stem cell mobilization received a combination of G-CSF (morning of Day 1-5) and plerixafor (evening of Day 4). Apheresis was performed on Day 5. G-CSF, plerixafor and apheresis were continued until at least 2 × 106/kg CD34+ cells were obtained in a maximum of 3 collections. Results: A mean of 2 plerixafor administrations was needed to reach ≥ 2 × 106/kg CD34+ cells. The overall cumulative success rate (defined as the proportion of patients achieving a successful collection after a maximum of 3 apheresis days) was 64%. Half of the heavily pretreated patients (≥ 3 prior chemotherapy regimens) could be mobilized successfully. Patients who received ≤ 2 prior chemotherapy regimens mobilized successfully in 75% of the cases. Thirteen patients (59.1%) underwent autologous stem cell transplantation with normal neutrophil and platelet recovery times. Conclusion: For patients failing previous mobilization attempts, the combination of plerixafor and G-CSF is a successful mobilizing strategy, even in poor mobilizers who received ≥ 3 prior chemotherapy regimens.

Giacalone G.,St Dimpna Hospital | Belgrado J.P.,Free University of Colombia | Bourgeois P.,Institute Bordet | Bracale P.,Free University of Colombia | And 2 more authors.
European Journal of Lymphology and Related Problems | Year: 2011

The quest of imaging the superficial lymphatic network with the help of contrasting products started already more than 200 years ago. Because of the physiological specificity, the limpidness and the smallness of lymphatic vessels, researchers have always had a difficult task in the search of a specific tracer, that could be sensitive enough for lymphatics, affordable and suitable for in vivo examinations with a minimum of risk. Indocyanine green has already been used in angiology, but is new in lymphology. Its application in lymphology completes in an original manner the arsenal of imaging tools in this field. A specific camera, equipped with an infra-red diode and an uv-captor allows a mapping of the functional superficial lymphatic network after injection of Indocyanine green. A physiotherapist collaborating with the examinator by exerting manual lymphatic drainage during the examination, increases the amount of information produced by the images. Therefore, the surgeon, the clinician and the physiotherapist get precious indications for the follow-up and the therapeutic choices in the treatment of lymphoedema.

Maerevoet M.,Institute Bordet | Sattar L.,Institute Bordet | Bron D.,Institute Bordet | Gulbis B.,Service de Chimie Medicale | Pepersack T.,Service de Geriatrie
Revue Medicale de Bruxelles | Year: 2014

Anaemia is a problem that affects almost 10 % over 65 years and 20 % over 85 years. There is no physiological anaemia in the elderly. Any anaemia expresses the existence of a pathological process, regardless of its severity. Anaemia in the elderly is always associated with a poor prognosis that is in terms of mortality, morbidity and risk of fragility. The diagnostic approach to anemia in the elderly is the same as in younger individual. There are many causes of anaemia ; anaemia balance is a complex diagnostic process. Most anaemias are due to a deficiency, chronic inflammation or comorbidity. However, in the elderly, the etiology of anaemia is often multifactorial. In a number of cases remain unexplained anaemia. In a number of cases, anemia remain unexplained. Treatment of anaemia is the treatment of the cause, but specific therapeutic aspects to the elderly should be considered, as among other martial substitution or use of erythropoietin (EPO). © 2014, Bureau d'Information Medicale (A.M.U.B.) asbl. All rights reserved.

Jacobs F.,Free University of Colombia | Selleslag D.,AZ Sint Jan Hospital | Aoun M.,Institute Bordet | Sonet A.,Hopital University Of Mont Godinne | Gadisseur A.,University of Antwerp
European Journal of Clinical Microbiology and Infectious Diseases | Year: 2012

The purpose of this study was to evaluate efficacy and safety of voriconazole in patients with acute invasive aspergillosis (IA) in a real-life, clinical setting. This was a multicenter observational study in adult patients treated with voriconazole for invasive mycosis. The study evaluated clinical response, mortality, use of other licensed antifungal therapy (OLAT), and treatment duration. This sub-analysis evaluated treatment and outcome data specifically from adult patients with proven/probable IA, while safety data were assessed in patients with proven/probable/possible IA. Of the 141 patients enrolled, 113 were adults with proven/probable IA and six had possible IA. Voriconazole treatment duration ranged from 1 to 183 days (median, 49.5 days). Voriconazole was used exclusively in 64% (72/113) of patients and in combination/sequentially with OLAT in 36%. Overall successful treatment response was 50% (57/113 patients). Twelve percent (14/113) of patients were switched to OLAT, either because of insufficient response (four patients) or for safety reasons (10 patients). Overall and attributable (entirely or partially due to fungal infection) mortality rates were 52% (59/113) and 17%, respectively. Treatment-related adverse events were reported for 18% (22/119) of patients. This observational study confirms the results of previous clinical trials demonstrating voriconazole as an effective and safe agent for treatment of confirmed acute IA. © The Author(s) 2011. This article is published with open access at

Duray A.,University of Mons | Descamps G.,University of Mons | Arafa M.,University of Liège | Decaestecker C.,Institute of Pharmacy | And 9 more authors.
International Journal of Oncology | Year: 2011

The aim of this study was to determine the prevalence of human papillomavirus (HPV) in patients with laryngeal benign lesions (LBLs) and laryngeal squamous cell carcinomas (LSCCs) using a sensitive E6/E7 type-specific PCR. Paraffin-embedded samples from LBL (n=39) and LSCC patients (n=67) were evaluated for the presence of HPV DNA by GP5+/GP6+ consensus PCR and E6/E7 type-specific PCR for HPV types 6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66 and 68. In LSCCs, immunohistochemical staining of p16, p53 and EGFR was also assessed. The E6/E7 type-specific PCR showed that 44 out of 59 LSCC patients (i.e., 75%) had high-risk (hr) HPV types and that 27 out of 35 LBL patients (i.e., 77%) had hrHPV types. HPV-16 viral load was significantly higher in LSCC than in LBL patients (p<10 -6). The presence of hrHPV DNA did not correlate with the proportion of disease-free patients. Comparable levels of p16, p53 and EGFR expression were observed in the hrHPV+ tumor group (100% p16+, 56% p53+ and 97% EGFR+) and in the HPV- or low-risk (1r) HPV+ tumor group (92% p16+, 66% p53+ and 100% EGFR+). A very high prevalence of oncogenic HPV-16 was found in a series of benign and malignant laryngeal lesions. LSCC appears to be characterized by an active hrHPV infection. In LSCCs, the hrHPV+ subgroup had a similar prognosis (in terms of risk of recurrence) as the HPV- subgroup.

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