Le lymphome du manteau

peer reviewedLe lymphome du manteau représente 3 à 10% des lymphomes non hodgkiniens (LNH). Il est caractérisé par la translocation chromosomique t(11;14) (q13;32), qui est responsable d'une surexpression de la cycline D1. Cette dernière participe à l'oncongenèse en favorisant la progression du cycle cellulaire. L'âge médian au moment du diagnostic est compris entre 60 et 70 ans et le pronostic est assez sombre puisque la survie médiane est estimée à 4 ans. Chez la plupart des patients, le diagnostic est posé à un stade avancé de la maladie. Des sites extra-ganglionnaires sont souvent atteints. Le traitement actuel de première ligne est basé sur de la poly-chimiothérapie suivie, chez les patients jeunes, par une autogreffe de cellules souches hématopoïétiques. L'allogreffe de cellules souches hématopoïétiques après un conditionnement non-myéloablateur pourrait jouer un rôle chez les patients en rechute après autogreffe.Mantle cell lymphoma comprises 3 to 10% of non-Hodgkin's lymphomas. Cyclin D1 expression due to t(11;14) (q13;32) is considered as a hallmark of this lymphoma and plays a pivotal role in the pathophysiology of lymphoma transformation. Median age at diagnosis ranges from 60 to 70 years, and diagnosis is often made at an advances stage with widespread lymphadenopathy and extranodular (particularly bone marrow and gastrointestinal) infiltration. First line treatment consists of combination chemotherapy followed with autologous hematopoietic cell transplantation (HCT) in younger patients, while allogeneic HCT following non-myeloablative conditioning might have a role inpatients relapsing after autologous HCT

Erythropoietin therapy after allogeneic hematopoietic cell transplantation : a prospective randomized trial

We conducted a prospective randomized trial to assess hemoglobin (Hb) response to recombinant human erythropoietin (rhEPO) therapy after hematopoietic cell transplantation (HCT). Patients (n=131) were randomized (1:1) between no treatment (control arm) or erythropoietin (Neorecormon®) at 500 U/kg/week (EPO arm). Patients were also stratified in 3 cohorts: patients undergoing myeloablative HCT with rhEPO to start on day 28, patients given nonmyeloablative HCT (NMHCT) with rhEPO to start on day 28, and patients also given NMHCT but with rhEPO to start on day 0. The proportion of complete correctors (i.e. achieving Hb ≥ 13 g/dL) before day 126 post-transplant (primary endpoint) was 8.1% in the control arm (median not reached) and 63.1% in the EPO arm (median time 90 days) (p<0.001). Hb levels were higher and transfusions requirements decreased (p<0.001) in the EPO arm, but not during the first month in the nonmyeloablative cohort starting rhEPO on day 0. There was no difference in rates of thrombo-embolic events or other complications between the 2 arms. This is the first randomized trial to demonstrate that rhEPO therapy hastens erythroid recovery and decreases transfusion requirements when started one month after allogeneic HCT. There was no benefit to start rhEPO earlier after NMHCT

Recombinant human erythropoietin therapy after allogeneic hematopoietic cell transplantation with a nonmyeloablative conditioning regimen: low donor chimerism predicts for poor response.

peer reviewedPURPOSE: After allogeneic hematopoietic stem cell transplantation with nonmyeloablative conditioning (NMHCT), many patients experience prolonged anemia and require red blood cell (RBC) transfusions. We enrolled 60 consecutive patients undergoing NMHCT in a phase II trial to determine the optimal utilization of recombinant human erythropoietin (rHuEPO) therapy in this setting. PATIENTS AND METHODS: The first 14 NMHCT recipients did not receive rHuEPO (control group). Nineteen patients were scheduled to start rHuEPO on day 0 (EPO group 2) and 27 patients on day 28 after the transplant (EPO group 1). RHuEPO was administered subcutaneously once weekly at a dose of 500 U/kg/wk with the aim of achieving hemoglobin (Hb) levels of 13 g/dL. The 3 groups were well balanced for major characteristics. RESULTS: During the first month (p < 0.0001) as well as days 30 to 100 (p < 0.0001) and days 100 to 180 (p < 0.0001), Hb values were higher in patients receiving rHuEPO compared to those not receiving it. However, transfusion requirements were significantly decreased only in the first month in EPO group 2 (p = 0.0169). T-cell chimerism above 60% on day 42 was the best predictor of Hb response (p < 0.0001) or Hb correction (p = 0.0217), but myeloid chimerism above 90% also predicted for Hb response (p = 0.0069). Hb response was also decreased in patients receiving CD8-depleted grafts and increased in the few patients not receiving TBI, but only in univariate analysis. CONCLUSIONS: Anemia after NMHCT is sensitive to rHuEPO therapy, but less so than after conventional allogeneic HCT. RHuEPO decreases transfusion requirements only in the first 30 days posttransplant. T-cell chimerism below 60% on day 42 impaired Hb response, suggesting possible inhibition of donor erythropoiesis by residual recipient lymphocytes. A prospective randomized trial should be performed with rHuEPO starting on the day of transplantation to assess its clinical benefit in terms of transfusion requirements and quality of life

High Accuracy 65nm OPC Verification: Full Process Window Model vs. Critical Failure ORC

It is becoming more and more difficult to ensure robust patterning after OPC due to the continuous reduction of layout dimensions and diminishing process windows associated with each successive lithographic generation. Lithographers must guarantee high imaging fidelity throughout the entire range of normal process variations. The techniques of Mask Rule Checking (MRC) and Optical Rule Checking (ORC) have become mandatory tools for ensuring that OPC delivers robust patterning. However the first method relies on geometrical checks and the second one is based on a model built at best process conditions. Thus those techniques do not have the ability to address all potential printing errors throughout the process window (PW). To address this issue, a technique known as Critical Failure ORC (CFORC) was introduced that uses optical parameters from aerial image simulations. In CFORC, a numerical model is used to correlate these optical parameters with experimental data taken throughout the process window to predict printing errors. This method has proven its efficiency for detecting potential printing issues through the entire process window [1]. However this analytical method is based on optical parameters extracted via an optical model built at single process conditions. It is reasonable to expect that a verification method involving optical models built from several points throughout PW would provide more accurate predictions of printing errors for complex features. To verify this approach, compact optical models similar to those used for standard OPC were built and calibrated with experimental data measured at the PW limits. This model is then applied to various test patterns to predict potential printing errors. In this paper, a comparison between these two approaches is presented for the poly layer at 65 nm node patterning. Examples of specific failure predictions obtained separately with the two techniques are compared with experimental results. The details of implementing these two techniques on full product layouts are also included in this study

Impact of respiratory viruses in intensive care unit patient with community-acquired pneumonia : a one-year retrospective single-centre study.

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