Alain Delmer - Academia.edu (original) (raw)
Papers by Alain Delmer
The Lancet Haematology, 2016
Part one of the two-part SAWYER study predicted that subcutaneous rituximab 1600 mg would achieve... more Part one of the two-part SAWYER study predicted that subcutaneous rituximab 1600 mg would achieve trough serum concentrations that were non-inferior to those achieved with intravenous rituximab 500 mg/m(2) in patients with chronic lymphocytic leukaemia. In part two of the study, we aimed to confirm the pharmacokinetic non-inferiority of subcutaneous rituximab, and investigate its safety and efficacy. We did this phase 1b, open-label, randomised controlled non-inferiority study at 68 centres in 19 countries in Europe, North America, South America, and Australasia. Patients aged 18 years or older with untreated chronic lymphocytic leukaemia were randomly assigned, via an interactive voice-response system with a permuted block randomisation scheme (block size of ten), to receive subcutaneous rituximab 1600 mg or intravenous rituximab 500 mg/m(2) plus fludarabine and cyclophosphamide every 4 weeks for up to six cycles. In cycle one, all patients received intravenous rituximab 375 mg/m(2). Randomisation was stratified by Binet stage and fludarabine and cyclophosphamide administration route (oral vs intravenous). Study investigators and patients were not masked to group allocation, but allocation was concealed from the statistician, clinical scientist, and clinical pharmacologist. The primary endpoint was trough serum concentration at cycle five, with a non-inferiority margin of 0·8 for the adjusted geometric mean ratio of the subcutaneous to the intravenous dose. We did the primary analysis in patients in the intention-to-treat population with complete pharmacokinetic data (pharmacokinetic population). This trial is registered with ClinicalTrials.gov, number NCT01292603, and is ongoing, although the treatment stage is now complete. Between Aug 20, 2012, and June 17, 2013, we randomly assigned 176 patients to receive subcutaneous rituximab (n=88) or intravenous rituximab (n=88); 134 (76%) patients comprised the pharmacokinetic population. As of May 7, 2014, median follow-up was 13·9 months (IQR 11·9-16·0) for patients in the subcutaneous group and 14·1 months (11·6-16·5) for patients in the intravenous group. At cycle five, the geometric mean trough serum concentration in patients given subcutaneous rituximab was non-inferior to that in patients given intravenous rituximab (97·5 μg/mL vs 61·5 μg/mL), with an adjusted geometric mean ratio of 1·53 (90% CI 1·27-1·85). In the safety analysis, the proportion of patients reporting adverse events was similar between the subcutaneous and intravenous groups (all grades: 82 [96%] of 85 patients and 81 [91%] of 89 patients; serious adverse events: 25 [29%] and 29 [33%] patients; grade ≥3: 59 [69%] and 63 [71%] patients, respectively). The most common adverse event of grade 3 or higher was neutropenia (48 [56%] patients in the subcutaneous group and 46 [52%] patients in the intravenous group); the most common serious adverse event was febrile neutropenia (n=9 [11%] and n=4 [4%], respectively). We recorded administration-related reactions in 37 (44%) patients given subcutaneous rituximab and 40 (45%) patients given the intravenous dose, with differences between administration routes for injection-site erythema (n=10 [12%] and n=0, respectively) and nausea (n=2 [2%] and n=11 [12%], respectively). More patients reported local cutaneous reactions after subcutaneous rituximab (n=36 [42%]) than after intravenous rituximab (n=2 [2%]); most of these reactions were grade 1 or 2. When combined with fludarabine and cyclophosphamide, subcutaneous rituximab 1600 mg achieved trough serum concentrations that were pharmacokinetically non-inferior to those achieved with intravenous rituximab 500 mg/m(2), with a similar safety and efficacy profile between the two groups. Treatment with subcutaneous rituximab should allow patients with chronic lymphocytic leukaemia to receive clinical benefit from the drug via a more convenient delivery method than the intravenous route, and might also be used in combination regimens with approved and emerging oral regimens. F Hoffmann-La Roche.
PURPOSE/AIM Whole body diffusion weighted (wb dw) MRI appears as a promising functional technique... more PURPOSE/AIM Whole body diffusion weighted (wb dw) MRI appears as a promising functional technique for staging malignant lymphoma. The aim of this exhibit is to review wb dw sequences to be used, normal findings and lesion characteristics in patients with lymphoma. CONTENT ORGANIZATION To understand the basic principles underlying whole body diffusion weighted imaging To learn how to look at wb dw image set To review normal structures showing high signal intensity on wb dw sequences Using examples to identify nodal, extranodal and bone marrow involvement in patients with lymphomas To understand the pitfalls of using whole body diffusion weighted imaging SUMMARY After viewing this exhibit, participants will be able to: Discuss the state-of-the-art of whole body diffusion weighted MR imaging technique for evaluating lymphomas Recognize the normal MR imaging features when using wb dw sequences. Identify the wb dw imaging appearances of nodal and extranodal lesions.
British journal of clinical pharmacology, Jan 19, 2015
The aim of the phase Ib, two-part SAWYER study (BO25341; NCT01292603) was to investigate the phar... more The aim of the phase Ib, two-part SAWYER study (BO25341; NCT01292603) was to investigate the pharmacokinetics and safety of subcutaneous (SC) rituximab compared with intravenous (IV) rituximab, both in combination with fludarabine and cyclophosphamide (FC), as first-line treatment for patients with chronic lymphocytic leukaemia (CLL). During Part 1 (dose-finding), CLL patients received rituximab IV followed by a single dose of rituximab SC at one of three fixed doses (1400, 1600 or 1870 mg) in cycle 6. The primary objective was to identify a fixed SC dose that would achieve comparable rituximab serum trough concentrations (Ctrough ) to those achieved with the standard 4-weekly 500 mg/m(2) rituximab IV dose. Fifty-five patients received a fixed dose of rituximab SC; 16 received 1400 mg, 17 received 1600 mg and 22 received 1870 mg. The 1600 mg dose was predicted to achieve non-inferior Ctrough to standard rituximab IV treatment. The rituximab SC safety profile was comparable to rituxi...
Annales de médecine interne, 1995
The risk of malignant B cell lymphoma is increased in Sjögren's syndrome (SS). Orbital locali... more The risk of malignant B cell lymphoma is increased in Sjögren's syndrome (SS). Orbital localization seems infrequent. We report 4 cases of malignant lymphoma (ML) occurring in 4 women aged 47 to 77 years, with primary SS in 3 cases, located to the conjunctiva in 2 cases, the lacrymal gland in 1 case and the eyelid in 1 case. The interval between the diagnosis of SS and orbital ML varied from 6 months to 15 years. All 4 lymphomas were of the B cell type, low histopathologic grade, with monoclonal gammopathy in 1 case. Extraocular lymphoma was initially present in 1 case. ML remained localized in 2 cases with a follow-up of 4 and 6 years. Two patients treated by excisional biopsy alone are in complete remission 3 and 6 years later. The 2 other patients treated with orbital radiotherapy and chemotherapy died rapidly (transformation into a high grade malignancy in 1 case). We conclude that clinical, immunopathologic features, as well as prognosis and treatment of ocular adnexa ML in...
PURPOSE Whole body diffusion weighted (WB DW) MRI appears as a promising functional technique for... more PURPOSE Whole body diffusion weighted (WB DW) MRI appears as a promising functional technique for oncology purposes. The aim of the study was to investigate whether using 3T instead of 1.5T modifies the results of WB DW imaging for the staging of lymphoma with FDG-PET/CT as the standard of reference METHOD AND MATERIALS Twenty-three (n=23) patients with newly diagnosed lymphoma were evaluated at 3T and 1.5T using WB DW images and compared to PET/CT findings. Images were reviewed in consensus by two radiologists during separate sessions for assessment of image quality and lesion detection. True-positive, false positive and false-negative values were evaluated on a per-lesion basis. Tumor staging based on WB DW images at 3T and 1.5T was compared using the Ann Arbor staging system. RESULTS According to the Ann Arbor staging system using PET and bone marrow biopsy, disease was stage I in 5 patients, II in 5 patients, III in 3 patients, and IV in 10 patients. WB DW images at 1.5T receive...
Clinical Imaging, 2015
To compare 3T and 1.5T Whole Body Diffusion Weighted MRI (WB-DW-MRI) in patients at initial diagn... more To compare 3T and 1.5T Whole Body Diffusion Weighted MRI (WB-DW-MRI) in patients at initial diagnosis of lymphoma. Twenty-three patients were included. We performed a 3.0T and 1.5T WB-DW-MRI with 18 F-Fluoride Positron Emission Tomography Computed Tomography (PET-CT) as the reference standard. Image quality, lymph node, organ involvement, and Ann Arbor staging were evaluated. Major artifacts were found in 2/23 patients at 3.0T. Concordance was excellent between 1.5T and 3T for nodal (Intraclass Correlation Coefficient (CCI)=0.995), organ involvement (CCI=0.990), and Ann Arbor stages (k=0.967). A 3T WB-DW-MRI yields accurate assessment and staging of lymphoma comparable to 1.5T.
Therapeutic Drug Monitoring, 1999
Ophthalmology, 1996
ois D'Hermies, MIY Purpose: To present a new masquerade syndrome showing features of mucosalassoc... more ois D'Hermies, MIY Purpose: To present a new masquerade syndrome showing features of mucosalassociated lymphoid tissue (MALT) lymphoma associated with choroidal white dots and scleritis. Differentials including systemic lymphoma, central nervous system lymphoma, and etiologies of white-dot syndromes and scleritis are discussed.
Gastroenterologie Clinique Et Biologique, 2002
Haematologica
This study is a long-term follow-up analysis evaluating clinical outcome of patients with mantle-... more This study is a long-term follow-up analysis evaluating clinical outcome of patients with mantle-cell lymphoma treated by the sequential CHOP and DHAP chemotherapy followed by autografting. The median overall survival of 81 months (95% CI, 66-not reached) and the median event free survival of 51 months (95% CI, 43-not reached) confirm the improvement in outcome obtained by such protocol.
Médecine Nucléaire, 2009
Neurolymphomatose du nerf sciatique en TEP au FDG : à propos d'un cas et revue de la littérature ... more Neurolymphomatose du nerf sciatique en TEP au FDG : à propos d'un cas et revue de la littérature Neurolymphomatosis of the sciatic nerve and FDG PET: Case report and review
Médecine et Maladies Infectieuses, 2006
Legionellosis due to other species than Legionella pneumophila is rarely described in human cases... more Legionellosis due to other species than Legionella pneumophila is rarely described in human cases. It has been reported in immunocompromised patients with respiratory symptoms of pneumonia. We report a case of legionellosis in an immunocompromised 54-year-old man hospitalized for a blood transfusion. A routine pulmonary X- Ray was made and then a bronchoalveolar lavage was collected in which Legionella gormanii was identified. The diagnostic of legionellosis must be considered in all immunocompromised patients presenting with any pulmonary symptoms.
Annales de biologie clinique
Nocardia spp. are bacteria often implicated in pulmonary diseases and central nervous system infe... more Nocardia spp. are bacteria often implicated in pulmonary diseases and central nervous system infections, especially in immunocompromised patients. We report here the case of an immunocompromised woman presenting an insidious brain abcess initially treated as a cerebral stroke. Despite a cotrimoxazole and rifampicin treatment she did not improve. She died 3 month later after she stopped her treatment.
La Revue de Médecine Interne, 2008
Leukemia & Lymphoma, 2013
ABSTRACT Abstract We report a patient with stage IV aggressive B-cell lymphoma presenting with a ... more ABSTRACT Abstract We report a patient with stage IV aggressive B-cell lymphoma presenting with a leukemic phase and generalized lymphadenopathy. Lymph node biopsy was consistent with aggressive mantle cell lymphoma. Cytogenetic studies revealed t(4;8)(q21;q24) and complex t(11;14)(q13;q32) involving chromosome 17, with rearrangements of MYC, CCND1 and TP53 genes. The lymphoma was primary refractory to chemotherapy. The morphologic features and clinical outcome are similar to "double-hit" lymphomas and disease aggressiveness probably reflects the expression of both pro-proliferative oncoproteins myc and cyclin D1.
Annales de Pathologie, 2011
Communications affichées différenciés et dédifférenciés ne doit pas être méconnu en raison d'une ... more Communications affichées différenciés et dédifférenciés ne doit pas être méconnu en raison d'une prise en charge thérapeutique particulière. En conclusion, le diagnostic de liposarcome bien différencié ou dédifférencié doit être évoqué devant toute tumeur du cordon spermatique. Outre un examen morphologique et un immunomarquage soigneux, la CISH est un outil très prometteur pour le pathologiste pour confirmer ces diagnostics sur le plan moléculaire. Les anomalies chromosomiques des lymphomes B diffus à grandes cellules (LBDGC) s'observent dans 40 % des cas. Les plus fréquentes impliquent le gène BCL6 dans 30 % des cas. Dans les séries, il existe un réarrangement du gène MYC dans 10 % des cas. Les lymphomes « double/triple hit » sont définis selon l'OMS par la présence d'un réarrangement concomitant de MYC et BCL2/BCL6. Par assimilation, certains auteurs incluent le réarrangement concomitant des gènes MYC et CCND1. Leur fréquence varie de 0 à 12 % selon les séries. Objectif.-Caractérisation morphologique, immunohistochimique et cytogénétique de 7 cas de lymphomes B agressifs avec double hit. Matériel et méthodes.-Étude rétrospective de 7 cas de lymphomes B « double hit », diagnostiqués entre 2007 et 2011, ayant bénéficié d'un examen anatomopathologique avec immunohistochimie (CD20, CD10, Bcl2, Bcl6, Mum1, TdT, CD34, Ki67) et étude cytogénétique conventionnelle par caryotype complétée par FISH (sondes MYC, BCL6, BCL2 et CCND1) sur culots cytogénétique. Les résultats sont confrontés aux données clinico-biologiques et évolutives.
American journal of hematology, Jan 22, 2016
An adverse prognostic impact of statin use in lymphoma was first suspected from in vitro data sho... more An adverse prognostic impact of statin use in lymphoma was first suspected from in vitro data showing an impairment of anti-CD20 antibody binding. However, further clinical studies suggested an improved outcome associated with their use in hematological malignancies. In particular, a survival benefit was reported for patients with follicular lymphoma on statins. Our objective was to assess the outcome of follicular lymphoma patients treated in the PRIMA study with immunochemotherapy according to the use of statins. Among the 1217 patients enrolled in the PRIMA study, 1135 were included in the present study. Concomitant treatments at registration were available for all patients. Among those 1135 patients, 119 were on statins (10.4%) at diagnosis. Adverse events frequencies, event-free survival (EFS), time to next lymphoma treatment (TTNLT), time to next chemotherapy (TTNCT) and overall survival (OS) were evaluated according to the use of statins. The rates of overall and specific car...
The Lancet Haematology, 2016
Part one of the two-part SAWYER study predicted that subcutaneous rituximab 1600 mg would achieve... more Part one of the two-part SAWYER study predicted that subcutaneous rituximab 1600 mg would achieve trough serum concentrations that were non-inferior to those achieved with intravenous rituximab 500 mg/m(2) in patients with chronic lymphocytic leukaemia. In part two of the study, we aimed to confirm the pharmacokinetic non-inferiority of subcutaneous rituximab, and investigate its safety and efficacy. We did this phase 1b, open-label, randomised controlled non-inferiority study at 68 centres in 19 countries in Europe, North America, South America, and Australasia. Patients aged 18 years or older with untreated chronic lymphocytic leukaemia were randomly assigned, via an interactive voice-response system with a permuted block randomisation scheme (block size of ten), to receive subcutaneous rituximab 1600 mg or intravenous rituximab 500 mg/m(2) plus fludarabine and cyclophosphamide every 4 weeks for up to six cycles. In cycle one, all patients received intravenous rituximab 375 mg/m(2). Randomisation was stratified by Binet stage and fludarabine and cyclophosphamide administration route (oral vs intravenous). Study investigators and patients were not masked to group allocation, but allocation was concealed from the statistician, clinical scientist, and clinical pharmacologist. The primary endpoint was trough serum concentration at cycle five, with a non-inferiority margin of 0·8 for the adjusted geometric mean ratio of the subcutaneous to the intravenous dose. We did the primary analysis in patients in the intention-to-treat population with complete pharmacokinetic data (pharmacokinetic population). This trial is registered with ClinicalTrials.gov, number NCT01292603, and is ongoing, although the treatment stage is now complete. Between Aug 20, 2012, and June 17, 2013, we randomly assigned 176 patients to receive subcutaneous rituximab (n=88) or intravenous rituximab (n=88); 134 (76%) patients comprised the pharmacokinetic population. As of May 7, 2014, median follow-up was 13·9 months (IQR 11·9-16·0) for patients in the subcutaneous group and 14·1 months (11·6-16·5) for patients in the intravenous group. At cycle five, the geometric mean trough serum concentration in patients given subcutaneous rituximab was non-inferior to that in patients given intravenous rituximab (97·5 μg/mL vs 61·5 μg/mL), with an adjusted geometric mean ratio of 1·53 (90% CI 1·27-1·85). In the safety analysis, the proportion of patients reporting adverse events was similar between the subcutaneous and intravenous groups (all grades: 82 [96%] of 85 patients and 81 [91%] of 89 patients; serious adverse events: 25 [29%] and 29 [33%] patients; grade ≥3: 59 [69%] and 63 [71%] patients, respectively). The most common adverse event of grade 3 or higher was neutropenia (48 [56%] patients in the subcutaneous group and 46 [52%] patients in the intravenous group); the most common serious adverse event was febrile neutropenia (n=9 [11%] and n=4 [4%], respectively). We recorded administration-related reactions in 37 (44%) patients given subcutaneous rituximab and 40 (45%) patients given the intravenous dose, with differences between administration routes for injection-site erythema (n=10 [12%] and n=0, respectively) and nausea (n=2 [2%] and n=11 [12%], respectively). More patients reported local cutaneous reactions after subcutaneous rituximab (n=36 [42%]) than after intravenous rituximab (n=2 [2%]); most of these reactions were grade 1 or 2. When combined with fludarabine and cyclophosphamide, subcutaneous rituximab 1600 mg achieved trough serum concentrations that were pharmacokinetically non-inferior to those achieved with intravenous rituximab 500 mg/m(2), with a similar safety and efficacy profile between the two groups. Treatment with subcutaneous rituximab should allow patients with chronic lymphocytic leukaemia to receive clinical benefit from the drug via a more convenient delivery method than the intravenous route, and might also be used in combination regimens with approved and emerging oral regimens. F Hoffmann-La Roche.
PURPOSE/AIM Whole body diffusion weighted (wb dw) MRI appears as a promising functional technique... more PURPOSE/AIM Whole body diffusion weighted (wb dw) MRI appears as a promising functional technique for staging malignant lymphoma. The aim of this exhibit is to review wb dw sequences to be used, normal findings and lesion characteristics in patients with lymphoma. CONTENT ORGANIZATION To understand the basic principles underlying whole body diffusion weighted imaging To learn how to look at wb dw image set To review normal structures showing high signal intensity on wb dw sequences Using examples to identify nodal, extranodal and bone marrow involvement in patients with lymphomas To understand the pitfalls of using whole body diffusion weighted imaging SUMMARY After viewing this exhibit, participants will be able to: Discuss the state-of-the-art of whole body diffusion weighted MR imaging technique for evaluating lymphomas Recognize the normal MR imaging features when using wb dw sequences. Identify the wb dw imaging appearances of nodal and extranodal lesions.
British journal of clinical pharmacology, Jan 19, 2015
The aim of the phase Ib, two-part SAWYER study (BO25341; NCT01292603) was to investigate the phar... more The aim of the phase Ib, two-part SAWYER study (BO25341; NCT01292603) was to investigate the pharmacokinetics and safety of subcutaneous (SC) rituximab compared with intravenous (IV) rituximab, both in combination with fludarabine and cyclophosphamide (FC), as first-line treatment for patients with chronic lymphocytic leukaemia (CLL). During Part 1 (dose-finding), CLL patients received rituximab IV followed by a single dose of rituximab SC at one of three fixed doses (1400, 1600 or 1870 mg) in cycle 6. The primary objective was to identify a fixed SC dose that would achieve comparable rituximab serum trough concentrations (Ctrough ) to those achieved with the standard 4-weekly 500 mg/m(2) rituximab IV dose. Fifty-five patients received a fixed dose of rituximab SC; 16 received 1400 mg, 17 received 1600 mg and 22 received 1870 mg. The 1600 mg dose was predicted to achieve non-inferior Ctrough to standard rituximab IV treatment. The rituximab SC safety profile was comparable to rituxi...
Annales de médecine interne, 1995
The risk of malignant B cell lymphoma is increased in Sjögren's syndrome (SS). Orbital locali... more The risk of malignant B cell lymphoma is increased in Sjögren's syndrome (SS). Orbital localization seems infrequent. We report 4 cases of malignant lymphoma (ML) occurring in 4 women aged 47 to 77 years, with primary SS in 3 cases, located to the conjunctiva in 2 cases, the lacrymal gland in 1 case and the eyelid in 1 case. The interval between the diagnosis of SS and orbital ML varied from 6 months to 15 years. All 4 lymphomas were of the B cell type, low histopathologic grade, with monoclonal gammopathy in 1 case. Extraocular lymphoma was initially present in 1 case. ML remained localized in 2 cases with a follow-up of 4 and 6 years. Two patients treated by excisional biopsy alone are in complete remission 3 and 6 years later. The 2 other patients treated with orbital radiotherapy and chemotherapy died rapidly (transformation into a high grade malignancy in 1 case). We conclude that clinical, immunopathologic features, as well as prognosis and treatment of ocular adnexa ML in...
PURPOSE Whole body diffusion weighted (WB DW) MRI appears as a promising functional technique for... more PURPOSE Whole body diffusion weighted (WB DW) MRI appears as a promising functional technique for oncology purposes. The aim of the study was to investigate whether using 3T instead of 1.5T modifies the results of WB DW imaging for the staging of lymphoma with FDG-PET/CT as the standard of reference METHOD AND MATERIALS Twenty-three (n=23) patients with newly diagnosed lymphoma were evaluated at 3T and 1.5T using WB DW images and compared to PET/CT findings. Images were reviewed in consensus by two radiologists during separate sessions for assessment of image quality and lesion detection. True-positive, false positive and false-negative values were evaluated on a per-lesion basis. Tumor staging based on WB DW images at 3T and 1.5T was compared using the Ann Arbor staging system. RESULTS According to the Ann Arbor staging system using PET and bone marrow biopsy, disease was stage I in 5 patients, II in 5 patients, III in 3 patients, and IV in 10 patients. WB DW images at 1.5T receive...
Clinical Imaging, 2015
To compare 3T and 1.5T Whole Body Diffusion Weighted MRI (WB-DW-MRI) in patients at initial diagn... more To compare 3T and 1.5T Whole Body Diffusion Weighted MRI (WB-DW-MRI) in patients at initial diagnosis of lymphoma. Twenty-three patients were included. We performed a 3.0T and 1.5T WB-DW-MRI with 18 F-Fluoride Positron Emission Tomography Computed Tomography (PET-CT) as the reference standard. Image quality, lymph node, organ involvement, and Ann Arbor staging were evaluated. Major artifacts were found in 2/23 patients at 3.0T. Concordance was excellent between 1.5T and 3T for nodal (Intraclass Correlation Coefficient (CCI)=0.995), organ involvement (CCI=0.990), and Ann Arbor stages (k=0.967). A 3T WB-DW-MRI yields accurate assessment and staging of lymphoma comparable to 1.5T.
Therapeutic Drug Monitoring, 1999
Ophthalmology, 1996
ois D'Hermies, MIY Purpose: To present a new masquerade syndrome showing features of mucosalassoc... more ois D'Hermies, MIY Purpose: To present a new masquerade syndrome showing features of mucosalassociated lymphoid tissue (MALT) lymphoma associated with choroidal white dots and scleritis. Differentials including systemic lymphoma, central nervous system lymphoma, and etiologies of white-dot syndromes and scleritis are discussed.
Gastroenterologie Clinique Et Biologique, 2002
Haematologica
This study is a long-term follow-up analysis evaluating clinical outcome of patients with mantle-... more This study is a long-term follow-up analysis evaluating clinical outcome of patients with mantle-cell lymphoma treated by the sequential CHOP and DHAP chemotherapy followed by autografting. The median overall survival of 81 months (95% CI, 66-not reached) and the median event free survival of 51 months (95% CI, 43-not reached) confirm the improvement in outcome obtained by such protocol.
Médecine Nucléaire, 2009
Neurolymphomatose du nerf sciatique en TEP au FDG : à propos d'un cas et revue de la littérature ... more Neurolymphomatose du nerf sciatique en TEP au FDG : à propos d'un cas et revue de la littérature Neurolymphomatosis of the sciatic nerve and FDG PET: Case report and review
Médecine et Maladies Infectieuses, 2006
Legionellosis due to other species than Legionella pneumophila is rarely described in human cases... more Legionellosis due to other species than Legionella pneumophila is rarely described in human cases. It has been reported in immunocompromised patients with respiratory symptoms of pneumonia. We report a case of legionellosis in an immunocompromised 54-year-old man hospitalized for a blood transfusion. A routine pulmonary X- Ray was made and then a bronchoalveolar lavage was collected in which Legionella gormanii was identified. The diagnostic of legionellosis must be considered in all immunocompromised patients presenting with any pulmonary symptoms.
Annales de biologie clinique
Nocardia spp. are bacteria often implicated in pulmonary diseases and central nervous system infe... more Nocardia spp. are bacteria often implicated in pulmonary diseases and central nervous system infections, especially in immunocompromised patients. We report here the case of an immunocompromised woman presenting an insidious brain abcess initially treated as a cerebral stroke. Despite a cotrimoxazole and rifampicin treatment she did not improve. She died 3 month later after she stopped her treatment.
La Revue de Médecine Interne, 2008
Leukemia & Lymphoma, 2013
ABSTRACT Abstract We report a patient with stage IV aggressive B-cell lymphoma presenting with a ... more ABSTRACT Abstract We report a patient with stage IV aggressive B-cell lymphoma presenting with a leukemic phase and generalized lymphadenopathy. Lymph node biopsy was consistent with aggressive mantle cell lymphoma. Cytogenetic studies revealed t(4;8)(q21;q24) and complex t(11;14)(q13;q32) involving chromosome 17, with rearrangements of MYC, CCND1 and TP53 genes. The lymphoma was primary refractory to chemotherapy. The morphologic features and clinical outcome are similar to "double-hit" lymphomas and disease aggressiveness probably reflects the expression of both pro-proliferative oncoproteins myc and cyclin D1.
Annales de Pathologie, 2011
Communications affichées différenciés et dédifférenciés ne doit pas être méconnu en raison d'une ... more Communications affichées différenciés et dédifférenciés ne doit pas être méconnu en raison d'une prise en charge thérapeutique particulière. En conclusion, le diagnostic de liposarcome bien différencié ou dédifférencié doit être évoqué devant toute tumeur du cordon spermatique. Outre un examen morphologique et un immunomarquage soigneux, la CISH est un outil très prometteur pour le pathologiste pour confirmer ces diagnostics sur le plan moléculaire. Les anomalies chromosomiques des lymphomes B diffus à grandes cellules (LBDGC) s'observent dans 40 % des cas. Les plus fréquentes impliquent le gène BCL6 dans 30 % des cas. Dans les séries, il existe un réarrangement du gène MYC dans 10 % des cas. Les lymphomes « double/triple hit » sont définis selon l'OMS par la présence d'un réarrangement concomitant de MYC et BCL2/BCL6. Par assimilation, certains auteurs incluent le réarrangement concomitant des gènes MYC et CCND1. Leur fréquence varie de 0 à 12 % selon les séries. Objectif.-Caractérisation morphologique, immunohistochimique et cytogénétique de 7 cas de lymphomes B agressifs avec double hit. Matériel et méthodes.-Étude rétrospective de 7 cas de lymphomes B « double hit », diagnostiqués entre 2007 et 2011, ayant bénéficié d'un examen anatomopathologique avec immunohistochimie (CD20, CD10, Bcl2, Bcl6, Mum1, TdT, CD34, Ki67) et étude cytogénétique conventionnelle par caryotype complétée par FISH (sondes MYC, BCL6, BCL2 et CCND1) sur culots cytogénétique. Les résultats sont confrontés aux données clinico-biologiques et évolutives.
American journal of hematology, Jan 22, 2016
An adverse prognostic impact of statin use in lymphoma was first suspected from in vitro data sho... more An adverse prognostic impact of statin use in lymphoma was first suspected from in vitro data showing an impairment of anti-CD20 antibody binding. However, further clinical studies suggested an improved outcome associated with their use in hematological malignancies. In particular, a survival benefit was reported for patients with follicular lymphoma on statins. Our objective was to assess the outcome of follicular lymphoma patients treated in the PRIMA study with immunochemotherapy according to the use of statins. Among the 1217 patients enrolled in the PRIMA study, 1135 were included in the present study. Concomitant treatments at registration were available for all patients. Among those 1135 patients, 119 were on statins (10.4%) at diagnosis. Adverse events frequencies, event-free survival (EFS), time to next lymphoma treatment (TTNLT), time to next chemotherapy (TTNCT) and overall survival (OS) were evaluated according to the use of statins. The rates of overall and specific car...