Benjamin Carpentier - Academia.edu (original) (raw)

Papers by Benjamin Carpentier

Leukemia Research, May 1, 2022

Blood, Dec 7, 2017

Background. Streptococcus pneumoniae causes substantial morbidity and mortality from pneumonia, s... more Background. Streptococcus pneumoniae causes substantial morbidity and mortality from pneumonia, septicaemia and meningitis in myeloma primarilyrelated to severe hypogammaglobulinemia. In immunocompromised patients, pneumococcal vaccination is recommended as primeboost 13-valent conjugated vaccine (Prevnar13 ®) followed by 23-valent Pneumococcal polysaccharide (PS) vaccine (Pneumo23 ®) 1 to 2 months apart. However, there is a paucity of data in multiple myeloma (MM) to validate this approach. We aimed at analyzing subclass and isotype (IgG, IgG2, IgA and IgM) specific responses to pneumococcal vaccination. Method. We have prospectively included 28 NDMM. Serum was collected prior to vaccination and any treatment, then were sequentially collected at day 1 of each further cycle until treatment ended. 15 patients received both vaccinations Prevnar13® and Pneumo23® at the same time and 13 the prime boost. To assess the response to vaccination,VaccZyme™ (Binding Site) PCP anti-PS23 IgG, IgG2, IgA and IgM test was performed on every sample. In parallel, adverse events of infectious type were collected, with a particular attention topneumococcal infections. Results. The median age was 66, the M/F ratio was 0.6. All patients, but one, presented with hypogammaglobulinemia at diagnosis, of whom 21 had severe hypogammaglobulinemia Among the 20 patients included into this study, 5 reached CR, 7 VGPR, 4 PR, 3 SD and 1 had PD. Our data showed that pneumococcal vaccine responses occurred independently of the degree of disease control, and thus did not correlate with the depth of response rate Severe infection was observed in 5 patients, including two streptococcus oralis and one streptococcus salivarus septicemia (including one pneumonia and septicemia with S.oralis at diagnosis). No patient has presented Streptococcus pneumoniae infection. Conclusion . Most patients respond to pneumococcal vaccination in MM, independently of depth of hypogammaglobulinemia, vaccine schemas, with no difference according to the disease control. However, there was a clear drop in serum vaccine titers following ASCT. This data tends to confirm that MM can respond to vaccination at diagnosis and relapse, but not if the patients are further immunocompromised with a myeloablative treatment approach. Disclosures Facon: Amgen, Celgene: Speakers Bureau. Harding: The Binding Site: Employment. Leleu: AbbVie: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; BMS: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; Novartis: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; Celgene: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; Takeda: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; Amgen: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; Sanofi: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; Merck: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; Janssen: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; Pierre Fabre: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees.

The emergence of SARS-CoV-2 Omicron variant has led to a complete reconfiguration of the therapeu... more The emergence of SARS-CoV-2 Omicron variant has led to a complete reconfiguration of the therapeutic landscape, with most monoclonal antibodies having lost any neutralization activity. We report here a case series of 75 immunocompromised patients infected by the Omicron variant who benefited of convalescent plasma. At baseline, 49 (68%) of the participants had a WHO score of 5 and 23 (32%) a WHO score of 6. At day 28 the case fatality was 24%. We observed no significant difference in the clinical outcome between patients with hematological malignancies, solid organ transplantation or auto-immune diseases. These promising results require controlled studies.

British Journal of Haematology

American Journal of Hematology

American Journal of Hematology, 2021

Patients with chronic lymphocytic leukemia (CLL) exhibit a variety of skin lesions including most... more Patients with chronic lymphocytic leukemia (CLL) exhibit a variety of skin lesions including mostly non-specific cutaneous manifestations (such as cutaneous infections or exaggerated reactions to insect bite) and secondary cutaneous malignancies, as patients are at high risk of developing basal cell carcinoma, squamous cell carcinoma, melanoma, and Merkel cell carcinoma. Specific cutaneous infiltration by neoplastic B lymphocytes with clinically identifiable skin lesions, also called leukemia cutis (LC), is more uncommon and has seldom been reported in chronic lymphocytic leukemia. 1,2 While CLL is usually restricted to blood, lymph nodes, spleen and bone marrow, the origin of such cutaneous presentation is elusive. In CLL, a number of recurrent gene mutations have been described and support the clinical heterogeneity of the disease. 3 However, the association of these mutations and LC has not been systematically investigated. To gain insight into the genetic background of LC-CLL and a potential link with cutaneous infiltration, we retrospectively analyzed the clinical and molecular features of 46 patients with specific LC from centers of the French Innovative Leukemia Organization (FILO). To date, this is the largest cohort of CLL patients with LC with genetic characterization. The specific skin involvement by CLL was proven by biopsy for all patients included in the study (Figure 1(A)). We collected clinical data, peripheral blood cytogenetics assessed by FISH and conventional karyotype, immunoglobulin heavy chain gene (IGHV) mutational status and results of targeted next-generation sequencing (NGS) of genes frequently mutated in CLL, including TP53 (exon 2-11), NOTCH1 (exon 34-3 0 UTR), ATM (full gene), FBXW7 (exon 8-11), SF3B1 (exon 14-46), POT1 (exon 5-10), XPO1 (exon 15), BTK (exon 15), PLCG2 (exon 19, 20, 24), RPS15 (exon 4) and IKZF3 (exon 5). We identified 46 patients with LC-CLL [sex ratio = 0.45; median age 61.2 years (43-85)]. All patients were diagnosed with CLL prior to LC. Median time between skin manifestations and CLL was 5.4 years (1-18 years). The majority of patients were at an early stage of CLL when cutaneous lesions occurred (Binet A: 55%, Binet B: 29%, Binet C: 14%), but two patients presented with Richter's transformation. Patient and clinical characteristics are summarized in Table S1. A complete description of the skin manifestation was available in 38 cases. Skin lesions were either diffuse (n = 16), localized (n = 13)

British Journal of Haematology, 2021

Blood, 2020

I ntroduction Despite recent therapeutic progress in this field, the prognosis of elderly patient... more I ntroduction Despite recent therapeutic progress in this field, the prognosis of elderly patients with Primary (PCNSL) and Secondary Central Nervous System Lymphoma (SCNSL) remains poor, with a median OS of less than two years in most prospective studies. Patients with chemo refractory relapsed PCNSL within the first year from diagnosis have a median OS of 2-4 months. Activated B cell like subtype of Diffuse Large B Cell Lymphoma (DLBCL) and PCNSL relies on a chronically active B-cell receptor (BCR) signaling. Ibrutinib achieves CNS penetrance and has a high overall response rate in CNS lymphomas, but duration of response is short and curative potential is limited. A novel regimen that combines ibrutinib with temozolomide, etoposide, liposomal doxycycline, dexamethasone, and rituximab (Teddi-R) seems to be promising for this population but its tolerance is an issue in patients with advanced age and poor general condition, common features of many PCNSL patients., calling for an alle...

American Journal of Hematology, 2021

State Cancer Institute, Indira Gandhi Institute of Medical Sciences, Patna, India Cross Cancer In... more State Cancer Institute, Indira Gandhi Institute of Medical Sciences, Patna, India Cross Cancer Institute, Edmonton, Alberta, Canada Kings College Hospital NHS Foundation Trust, London, UK University Hospitals of Leicester NHS Trust, Leicester, UK City Clinical Hospital #40, Moscow, Russian Federation Baylor University Medical Center, Dallas, Texas, USA University of Nantes, Nantes, France Karyopharm Therapeutics, Newton, Massachusetts, USA Dana-Farber Cancer Institute, Boston, Massachusetts, USA Medical University of Silesia, Katowice, Poland

Blood, 2017

Background. Streptococcus pneumoniae causes substantial morbidity and mortality from pneumonia, s... more Background. Streptococcus pneumoniae causes substantial morbidity and mortality from pneumonia, septicaemia and meningitis in myeloma primarilyrelated to severe hypogammaglobulinemia. In immunocompromised patients, pneumococcal vaccination is recommended as primeboost 13-valent conjugated vaccine (Prevnar13 ®) followed by 23-valent Pneumococcal polysaccharide (PS) vaccine (Pneumo23 ®) 1 to 2 months apart. However, there is a paucity of data in multiple myeloma (MM) to validate this approach. We aimed at analyzing subclass and isotype (IgG, IgG2, IgA and IgM) specific responses to pneumococcal vaccination. Method. We have prospectively included 28 NDMM. Serum was collected prior to vaccination and any treatment, then were sequentially collected at day 1 of each further cycle until treatment ended. 15 patients received both vaccinations Prevnar13® and Pneumo23® at the same time and 13 the prime boost. To assess the response to vaccination,VaccZyme™ (Binding Site) PCP anti-PS23 IgG, Ig...

European Journal of Haematology, 2021

Despite recent therapeutic advances the outcome of elderly or frail patients with Recurrent/Refra... more Despite recent therapeutic advances the outcome of elderly or frail patients with Recurrent/Refractory (R/R) Primary (PCNSL) and Secondary CNS Lymphoma (SCNSL) is particularly dire. We retrospectively analyzed 22 immunocompetent adults with R/R PCNSL or SCNSL treated with both temozolomide and ibrutinib in five French centers, from June 2015 to January 2020. The median age at treatment initiation was 71 (range, 44 - 89 years). All patients had relapsed (n=6) or refractory (n=16) disease, after a median of two lines of therapy (range, 1-3). The median Charlson Comorbidity Index was 5 (range, 2-8). Patients received a median of 3.2 cycles (1-19 cycles). The best overall response rate was 55% (12/22) including three (13.6%) complete responses. After a median follow-up of 18.2 months (range, 5.1 - 61.7), the median progression-free survival (PFS) and overall survival (OS) were 5.3 months (95% confidence interval [CI]; 3.10 - ∞) and 8.9 months (95% CI; 5.2 - ∞) respectively. Among responders, the median PFS and OS were 11.7 months (95% CI; 7 - ∞) and 21.8 months (95% CI; 10 - ∞) respectively. Our data suggest temozolomide combined with ibrutinib displayed clinical activity with manageable side effects might be an option in these frail R/R CNS lymphomas in unmet need.

Infectious Diseases Now, 2021

Here we present the case of an hepato-splenic-Tγδ-cell lymphoma interestingly occurring in a non-... more Here we present the case of an hepato-splenic-Tγδ-cell lymphoma interestingly occurring in a non-immunocompromised patient, with profuse telangiectasias giving originally misleading orientation towards the diagnosis of B angiotropic lymphoma.

Current Research in Translational Medicine, 2017

Despite recent therapeutic improvements, invasive fungal infections remain a major concern in hem... more Despite recent therapeutic improvements, invasive fungal infections remain a major concern in hematological practice. Among them, invasive aspergillosis (IA), caused by Aspergillus fumigatus comes second in terms of frequency (after Candida infections) and first in terms of mortality [1,2]. Importantly, IA frequency has significantly increased these last decades in Europe and in the United States of America [3,4]. Severity and prognosis of IA are related to the patient immunosuppression degree. The initial symptoms of IA are often rather poor and non-specific. The diagnosis is difficult and based on multiple clinical, radiological, mycological and serological features [5], leading to frequent delay in appropriate treatment. Consequently, unfavorable outcome is usual, which emphasizes the need for an early diagnosis. Patients with hematological malignancies represent a heterogeneous population. The risk of developing IA depends on the specific deficiencies in host defense mechanisms, which differ according to the underlying disease and the treatment received [6,7]. In addition, it has been shown that host immunosuppression may influence the radiologic presentation [8] and the prognosis [9]. The two populations at high risk of developing IA are patients treated for an acute leukemia and those undergoing allo-SCT [10,11]. However,

Blood, Jan 7, 2015

Chronic myelomonocytic leukemia (CMML) is a myelodysplastic syndrome/ myeloproliferative neoplasm... more Chronic myelomonocytic leukemia (CMML) is a myelodysplastic syndrome/ myeloproliferative neoplasm whose diagnosis is currently based on the elevation of peripheral blood monocytes to more than 1.10(9)/L, measured over at least 3 months. Diagnosis can be ambiguous, e.g. with pre-fibrotic myelofibrosis or reactive monocytosis. We set up a multi-parameter flow cytometry assay to distinguish CD14(+)/CD16(-) classical from CD14(+)/CD16(+) intermediate and CD14(low)/CD16(+) non-classical monocyte subsets in peripheral blood mononucleated cells and in total blood samples. Compared to healthy donors and patients with a reactive monocytosis or another hematological malignancy, CMML patients demonstrate a characteristic increase in the fraction of CD14(+)/CD16(-) cells (cut-off value, 94.0%), The associated specificity and sensitivity were 95.1% and 90.6% in the learning set (175 samples), 94.1% and 91.9% in the validation set (307 samples), respectively. The accumulation of classical monocyt...

Annales de Dermatologie et de Vénéréologie, 2019

Leukemia Research, May 1, 2022

Blood, Dec 7, 2017

Background. Streptococcus pneumoniae causes substantial morbidity and mortality from pneumonia, s... more Background. Streptococcus pneumoniae causes substantial morbidity and mortality from pneumonia, septicaemia and meningitis in myeloma primarilyrelated to severe hypogammaglobulinemia. In immunocompromised patients, pneumococcal vaccination is recommended as primeboost 13-valent conjugated vaccine (Prevnar13 ®) followed by 23-valent Pneumococcal polysaccharide (PS) vaccine (Pneumo23 ®) 1 to 2 months apart. However, there is a paucity of data in multiple myeloma (MM) to validate this approach. We aimed at analyzing subclass and isotype (IgG, IgG2, IgA and IgM) specific responses to pneumococcal vaccination. Method. We have prospectively included 28 NDMM. Serum was collected prior to vaccination and any treatment, then were sequentially collected at day 1 of each further cycle until treatment ended. 15 patients received both vaccinations Prevnar13® and Pneumo23® at the same time and 13 the prime boost. To assess the response to vaccination,VaccZyme™ (Binding Site) PCP anti-PS23 IgG, IgG2, IgA and IgM test was performed on every sample. In parallel, adverse events of infectious type were collected, with a particular attention topneumococcal infections. Results. The median age was 66, the M/F ratio was 0.6. All patients, but one, presented with hypogammaglobulinemia at diagnosis, of whom 21 had severe hypogammaglobulinemia Among the 20 patients included into this study, 5 reached CR, 7 VGPR, 4 PR, 3 SD and 1 had PD. Our data showed that pneumococcal vaccine responses occurred independently of the degree of disease control, and thus did not correlate with the depth of response rate Severe infection was observed in 5 patients, including two streptococcus oralis and one streptococcus salivarus septicemia (including one pneumonia and septicemia with S.oralis at diagnosis). No patient has presented Streptococcus pneumoniae infection. Conclusion . Most patients respond to pneumococcal vaccination in MM, independently of depth of hypogammaglobulinemia, vaccine schemas, with no difference according to the disease control. However, there was a clear drop in serum vaccine titers following ASCT. This data tends to confirm that MM can respond to vaccination at diagnosis and relapse, but not if the patients are further immunocompromised with a myeloablative treatment approach. Disclosures Facon: Amgen, Celgene: Speakers Bureau. Harding: The Binding Site: Employment. Leleu: AbbVie: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; BMS: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; Novartis: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; Celgene: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; Takeda: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; Amgen: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; Sanofi: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; Merck: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; Janssen: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees; Pierre Fabre: Consultancy, Honoraria, Membership on an entity9s Board of Directors or advisory committees.

The emergence of SARS-CoV-2 Omicron variant has led to a complete reconfiguration of the therapeu... more The emergence of SARS-CoV-2 Omicron variant has led to a complete reconfiguration of the therapeutic landscape, with most monoclonal antibodies having lost any neutralization activity. We report here a case series of 75 immunocompromised patients infected by the Omicron variant who benefited of convalescent plasma. At baseline, 49 (68%) of the participants had a WHO score of 5 and 23 (32%) a WHO score of 6. At day 28 the case fatality was 24%. We observed no significant difference in the clinical outcome between patients with hematological malignancies, solid organ transplantation or auto-immune diseases. These promising results require controlled studies.

British Journal of Haematology

American Journal of Hematology

American Journal of Hematology, 2021

Patients with chronic lymphocytic leukemia (CLL) exhibit a variety of skin lesions including most... more Patients with chronic lymphocytic leukemia (CLL) exhibit a variety of skin lesions including mostly non-specific cutaneous manifestations (such as cutaneous infections or exaggerated reactions to insect bite) and secondary cutaneous malignancies, as patients are at high risk of developing basal cell carcinoma, squamous cell carcinoma, melanoma, and Merkel cell carcinoma. Specific cutaneous infiltration by neoplastic B lymphocytes with clinically identifiable skin lesions, also called leukemia cutis (LC), is more uncommon and has seldom been reported in chronic lymphocytic leukemia. 1,2 While CLL is usually restricted to blood, lymph nodes, spleen and bone marrow, the origin of such cutaneous presentation is elusive. In CLL, a number of recurrent gene mutations have been described and support the clinical heterogeneity of the disease. 3 However, the association of these mutations and LC has not been systematically investigated. To gain insight into the genetic background of LC-CLL and a potential link with cutaneous infiltration, we retrospectively analyzed the clinical and molecular features of 46 patients with specific LC from centers of the French Innovative Leukemia Organization (FILO). To date, this is the largest cohort of CLL patients with LC with genetic characterization. The specific skin involvement by CLL was proven by biopsy for all patients included in the study (Figure 1(A)). We collected clinical data, peripheral blood cytogenetics assessed by FISH and conventional karyotype, immunoglobulin heavy chain gene (IGHV) mutational status and results of targeted next-generation sequencing (NGS) of genes frequently mutated in CLL, including TP53 (exon 2-11), NOTCH1 (exon 34-3 0 UTR), ATM (full gene), FBXW7 (exon 8-11), SF3B1 (exon 14-46), POT1 (exon 5-10), XPO1 (exon 15), BTK (exon 15), PLCG2 (exon 19, 20, 24), RPS15 (exon 4) and IKZF3 (exon 5). We identified 46 patients with LC-CLL [sex ratio = 0.45; median age 61.2 years (43-85)]. All patients were diagnosed with CLL prior to LC. Median time between skin manifestations and CLL was 5.4 years (1-18 years). The majority of patients were at an early stage of CLL when cutaneous lesions occurred (Binet A: 55%, Binet B: 29%, Binet C: 14%), but two patients presented with Richter's transformation. Patient and clinical characteristics are summarized in Table S1. A complete description of the skin manifestation was available in 38 cases. Skin lesions were either diffuse (n = 16), localized (n = 13)

British Journal of Haematology, 2021

Blood, 2020

I ntroduction Despite recent therapeutic progress in this field, the prognosis of elderly patient... more I ntroduction Despite recent therapeutic progress in this field, the prognosis of elderly patients with Primary (PCNSL) and Secondary Central Nervous System Lymphoma (SCNSL) remains poor, with a median OS of less than two years in most prospective studies. Patients with chemo refractory relapsed PCNSL within the first year from diagnosis have a median OS of 2-4 months. Activated B cell like subtype of Diffuse Large B Cell Lymphoma (DLBCL) and PCNSL relies on a chronically active B-cell receptor (BCR) signaling. Ibrutinib achieves CNS penetrance and has a high overall response rate in CNS lymphomas, but duration of response is short and curative potential is limited. A novel regimen that combines ibrutinib with temozolomide, etoposide, liposomal doxycycline, dexamethasone, and rituximab (Teddi-R) seems to be promising for this population but its tolerance is an issue in patients with advanced age and poor general condition, common features of many PCNSL patients., calling for an alle...

American Journal of Hematology, 2021

State Cancer Institute, Indira Gandhi Institute of Medical Sciences, Patna, India Cross Cancer In... more State Cancer Institute, Indira Gandhi Institute of Medical Sciences, Patna, India Cross Cancer Institute, Edmonton, Alberta, Canada Kings College Hospital NHS Foundation Trust, London, UK University Hospitals of Leicester NHS Trust, Leicester, UK City Clinical Hospital #40, Moscow, Russian Federation Baylor University Medical Center, Dallas, Texas, USA University of Nantes, Nantes, France Karyopharm Therapeutics, Newton, Massachusetts, USA Dana-Farber Cancer Institute, Boston, Massachusetts, USA Medical University of Silesia, Katowice, Poland

Blood, 2017

Background. Streptococcus pneumoniae causes substantial morbidity and mortality from pneumonia, s... more Background. Streptococcus pneumoniae causes substantial morbidity and mortality from pneumonia, septicaemia and meningitis in myeloma primarilyrelated to severe hypogammaglobulinemia. In immunocompromised patients, pneumococcal vaccination is recommended as primeboost 13-valent conjugated vaccine (Prevnar13 ®) followed by 23-valent Pneumococcal polysaccharide (PS) vaccine (Pneumo23 ®) 1 to 2 months apart. However, there is a paucity of data in multiple myeloma (MM) to validate this approach. We aimed at analyzing subclass and isotype (IgG, IgG2, IgA and IgM) specific responses to pneumococcal vaccination. Method. We have prospectively included 28 NDMM. Serum was collected prior to vaccination and any treatment, then were sequentially collected at day 1 of each further cycle until treatment ended. 15 patients received both vaccinations Prevnar13® and Pneumo23® at the same time and 13 the prime boost. To assess the response to vaccination,VaccZyme™ (Binding Site) PCP anti-PS23 IgG, Ig...

European Journal of Haematology, 2021

Despite recent therapeutic advances the outcome of elderly or frail patients with Recurrent/Refra... more Despite recent therapeutic advances the outcome of elderly or frail patients with Recurrent/Refractory (R/R) Primary (PCNSL) and Secondary CNS Lymphoma (SCNSL) is particularly dire. We retrospectively analyzed 22 immunocompetent adults with R/R PCNSL or SCNSL treated with both temozolomide and ibrutinib in five French centers, from June 2015 to January 2020. The median age at treatment initiation was 71 (range, 44 - 89 years). All patients had relapsed (n=6) or refractory (n=16) disease, after a median of two lines of therapy (range, 1-3). The median Charlson Comorbidity Index was 5 (range, 2-8). Patients received a median of 3.2 cycles (1-19 cycles). The best overall response rate was 55% (12/22) including three (13.6%) complete responses. After a median follow-up of 18.2 months (range, 5.1 - 61.7), the median progression-free survival (PFS) and overall survival (OS) were 5.3 months (95% confidence interval [CI]; 3.10 - ∞) and 8.9 months (95% CI; 5.2 - ∞) respectively. Among responders, the median PFS and OS were 11.7 months (95% CI; 7 - ∞) and 21.8 months (95% CI; 10 - ∞) respectively. Our data suggest temozolomide combined with ibrutinib displayed clinical activity with manageable side effects might be an option in these frail R/R CNS lymphomas in unmet need.

Infectious Diseases Now, 2021

Here we present the case of an hepato-splenic-Tγδ-cell lymphoma interestingly occurring in a non-... more Here we present the case of an hepato-splenic-Tγδ-cell lymphoma interestingly occurring in a non-immunocompromised patient, with profuse telangiectasias giving originally misleading orientation towards the diagnosis of B angiotropic lymphoma.

Current Research in Translational Medicine, 2017

Despite recent therapeutic improvements, invasive fungal infections remain a major concern in hem... more Despite recent therapeutic improvements, invasive fungal infections remain a major concern in hematological practice. Among them, invasive aspergillosis (IA), caused by Aspergillus fumigatus comes second in terms of frequency (after Candida infections) and first in terms of mortality [1,2]. Importantly, IA frequency has significantly increased these last decades in Europe and in the United States of America [3,4]. Severity and prognosis of IA are related to the patient immunosuppression degree. The initial symptoms of IA are often rather poor and non-specific. The diagnosis is difficult and based on multiple clinical, radiological, mycological and serological features [5], leading to frequent delay in appropriate treatment. Consequently, unfavorable outcome is usual, which emphasizes the need for an early diagnosis. Patients with hematological malignancies represent a heterogeneous population. The risk of developing IA depends on the specific deficiencies in host defense mechanisms, which differ according to the underlying disease and the treatment received [6,7]. In addition, it has been shown that host immunosuppression may influence the radiologic presentation [8] and the prognosis [9]. The two populations at high risk of developing IA are patients treated for an acute leukemia and those undergoing allo-SCT [10,11]. However,

Blood, Jan 7, 2015

Chronic myelomonocytic leukemia (CMML) is a myelodysplastic syndrome/ myeloproliferative neoplasm... more Chronic myelomonocytic leukemia (CMML) is a myelodysplastic syndrome/ myeloproliferative neoplasm whose diagnosis is currently based on the elevation of peripheral blood monocytes to more than 1.10(9)/L, measured over at least 3 months. Diagnosis can be ambiguous, e.g. with pre-fibrotic myelofibrosis or reactive monocytosis. We set up a multi-parameter flow cytometry assay to distinguish CD14(+)/CD16(-) classical from CD14(+)/CD16(+) intermediate and CD14(low)/CD16(+) non-classical monocyte subsets in peripheral blood mononucleated cells and in total blood samples. Compared to healthy donors and patients with a reactive monocytosis or another hematological malignancy, CMML patients demonstrate a characteristic increase in the fraction of CD14(+)/CD16(-) cells (cut-off value, 94.0%), The associated specificity and sensitivity were 95.1% and 90.6% in the learning set (175 samples), 94.1% and 91.9% in the validation set (307 samples), respectively. The accumulation of classical monocyt...

Annales de Dermatologie et de Vénéréologie, 2019