Candidose hépatosplénique ou disséminée après traitement de leucémie aiguë lymphoblastique à propos de deux cas

RENNES1-BU Santé (352382103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Detection of the CALR mutation in the diagnosis of splanchnic vein thrombosis

International audienc

Etat des lieux du test KRAS chez des patients atteints d'un cancer colorectal métastatique, en France en 2011 - Etude Flash-KRAS

National audienc

Étude Flash KRAS : étude transversale observationnelle, rétrospective, faisant un état des lieux du test KRAS en 2011 chez des patients ayant commencé récemment un traitement de première ligne pour un cancer colorectal métastatique (CCRm) : méthodologie de l'étude et premiers résultats

Published in Annales de Pathologie 31(5), Supplement, page S142National audienceIntroduction.- Le cetuximab est un anticorps monoclonal anti-EGFR indiqué dans le traitement du cancer colorectal métastatique (CCRm). Il a été démontré qu'une tumeur dont le gène KRAS est muté ne répondait pas au traitement anti-EGFR. Il est donc nécessaire avant la prescription d'un anti-EGFR (AMM modifiée en 2008) de rechercher le statut mutationnel KRAS au niveau de la tumeur colorectale. Dans ce contexte, l'étude Flash-KRAS a donc été mise en place afin de décrire les pratiques actuelles concernant le génotypage KRAS. Objectifs.- L'objectif principal est d'évaluer le taux de prescription du test KRAS chez des patients ayant commencé un traitement de première ligne d'un cancer colorectal métastatique. Les objectifs secondaires sont variés et vont permettre de décrire les délais et les techniques utilisées pour le génotypage KRAS, les raisons éventuelles de non recourt à ce test, décrire et analyser les caractéristiques cliniques des patients et les traitements de première ligne métastatique prévus et ceux reçus. Méthodes.- Flash-KRAS est une étude pharmaco-épidémiologique nationale, rétrospective, non interventionnelle, multicentrique et de courte durée. Durant 2 semaines (du 28 mars au 8 avril 2011), tous les centres participant devaient inclure chaque patient qui était vu à l'hôpital pour une consultation, en HDJ ou en hospitalisation conventionnelle et ayant commencé un traitement de première ligne entre le 1er janvier et le 27 mars 2011. Résultats.- Plus de 1700 cliniciens hospitaliers (oncologues, gastro-entérologues ou radiothérapeutes) ont été sollicités par courrier et téléphone pour participer. Trois cent soixante-six médecins ont répondu positivement. À la date du 16 mai 2011, date limite de retour des questionnaires, 149 médecins ont participé activement à l'étude et ont renvoyé 501 questionnaires patients. Le nombre moyen de questionnaires patient par médecin était de 3,4 (1-14). Discussion.- Les données sont en cours d'analyse et seront présentées lors du congrès. Conclusion.- Il s'agit de la première étude observationnelle rétrospective portant sur une grande cohorte de patients permettant de faire un état des lieux du génotypage KRAS en 2011 en France. Trois ans après la mise en place de la recherche des mutations KRAS dans le cadre d'un traitement par anti-EGFR pour un CCRm, cette étude nous permettra de faire un état des lieux et d'évaluer l'implantation en routine de ce biomarqueur

Trim33/Tif1γ is involved in late stages of granulomonopoiesis in mice.

IF 2.303International audienceTrim33/Tif1γ (Trim33) is a member of the tripartite motif family. Using a conditional hematopoietic-specific Trim33 knock-out (Trim33(Δ/Δ)) mouse, we showed previously that Trim33 deficiency in hematopoietic stem cells leads to severe defects in hematopoiesis, resembling the main features of human chronic myelomonocytic leukemia. We also demonstrated that Trim33 is involved in hematopoietic aging through TGFβ signaling. Nevertheless, how Trim33 contributes to the terminal stages of myeloid differentiation remains to be clarified. We reveal here the crucial role of Trim33 expression in the control of mature granulomonocytic differentiation. An important component of Trim33-deficient mice is the alteration of myeloid differentiation, as characterized by dysplastic features, abnormal granulocyte and monocyte maturation, and the expansion of CD11b(+)Ly6G(high)Ly6C(low) myeloid cells, which share some features with polymorphonuclear-myeloid-derived suppressor cells. Moreover, in Trim33(Δ/Δ) mice, we observed the alteration of CSF-1-mediated macrophage differentiation in association with the lack of Csf-1 receptor. Altogether, these results indicate that Trim33 deficiency leads to the expansion of a subset of myeloid cells characterizing the myelodysplastic/myeloproliferative neoplasm

Review of the current status of KRAS mutation testing in France in 2011: The Flash-KRAS study

Abstract published in Journal of Clinical Oncology, vol. 30, 2012, abstract e14129International audienceBackground: KRAS testing is required before treatment initiation of cetuximab in the management of metastatic colorectal cancer (mCRC). The objective of the study was to examine the current situation in 2011 regarding KRAS testing in the initial management of mCRC. Methods: This observational, retrospective, national study was carried out between March 28th and April 8th 2011. During this period 538 patients with mCRC were included across 160 french hospitals. The main objective was to assess the rate of KRAS testing in patients who had started first line (L1) treatment for mCRC. The secondary objectives were to describe the time taken and techniques used for KRAS testing, the possible reasons this test was not requested, to describe and analyse the clinical characteristics of the patients and the planned L1 treatments and those finally received. Results: KRAS testing was carried out for 433 patients (81.1%) and not carried out for 101 patients (18.9%). The main reasons for not requesting the KRAS status were (several answers possible): anti-EGFR not prescribed (n=58), candidate for surgery (n=8), samples not useable (n=5), age of the patient (n=3), other (n=24), data missing (n=13). The genotyping results were available after a mean delay of 23.6 ± 28.2 days. The KRAS testing was requested by an oncologist (45.5%), a gastroenterologist (31%), a surgeon (11.2%), a pathologist (7.2%) or a multidisciplinary group (5.1%) approximately 15 days (-66.5;33.6) median (min ; max) after the diagnosis of metastases, and 15 days (-66.9;3.7) median (min ; max) before the start of L1 treatment. Result of KRAS status had not been received before the L1 treatment was chosen in 56.6% of the patients. For patients with wild-type KRAS status whose therapeutic management was modified after the result of KRAS testing (n=108), this change was a prescription of an anti-EGFR in 77.8% of the cases. Conclusions: The Flash-KRAS study is the first one to assess the current modalities of KRAS genotyping in France. It shows that in 2011 the KRAS test is an integral part of the management of patients with mCRC. Nonetheless, it shows disparities between regions in terms of time to obtain results, which need to be improved to be compatible with the therapeutic management

The KRAS mutation detection within the initial management of patients with metastatic colorectal cancer: a status report in France in 2011

International audienceBACKGROUND: The detection of KRAS mutations is mandatory to initiate an anti-epidermal growth factor receptor (EGFR) antibody in the treatment of metastatic colorectal carcinoma (mCRC). PATIENTS AND METHODS: This observational retrospective study was performed in 160 French centres during a 2-week period in 2011. Its main objective was to evaluate the rate of KRAS testing in patients with mCRC having initiated their first-line therapy. Secondary objectives included time of process, techniques used and reasons for non-prescription. RESULTS: Five hundred and thirty eight mCRC patients (67.1 ± 11.3 years, synchronous metastases: 69.9%) were enrolled in the study. KRAS testing was prescribed in 81.1% of patients, in a median of 15 days after the diagnosis of metastases, and of 15 days prior to the initiation of the first-line metastatic chemotherapy. KRAS status was available for 87% of patients, after 23.6 ± 28.2 days, but after the choice of the first-line therapy in 56.6% of patients. Heterogeneity of reception time was noteworthy within regions (8.3 ± 7 days to 38.8 ± 101 days). KRAS testing was not prescribed mainly due to the planned non-prescription of an anti-EGFR antibody. CONCLUSION: This study confirmed that KRAS testing is definitely part of the management of most of mCRC patients, despite discrepancies observed in the rate of prescription and the time of results