Salvage high-dose chemotherapy in female patients with relapsed/refractory germ-cell tumors: A retrospective analysis of the European Group for Blood and Marrow Transplantation (EBMT)

Background: High-dose chemotherapy (HDC) with hematopoietic progenitor cell transplantation is a standard option for relapsed/refractory testicular germ-cell tumor (GCT), but only few data have been reported in female patients with GCT. We conducted a retrospective analysis of female patients with GCT treated with HDC and registered with the European Society for Blood and Marrow Transplantation. Patients and methods: Between 1985 and 2013, 60 registered female patients with GCT, median age 27 years (range 15-48), were treated with salvage HDC. Forty patients (67%) had primary ovarian GCT, 8 (13%) mediastinal, 7 (12%) retroperitoneal and 5 (8%) other primary sites/unknown. Twenty-two patients (37%) received HDC as second-line therapy, 29 (48%) as third-line, and 9 (15%) as fourth- to sixth-line. Nine of 60 patients (15%) received HDC as late-intensification with no evidence of metastasis before HDC. The conditioning HDC regimens comprised carboplatin in 51 of 60 cases (85%), and consisted of a single HDC cycle in 31 cases (52%), a multi-cycle HDC regimen in 29 (48%). Results: Nine cases who underwent late intensification HDC were not evaluable for response. Of the other 51 assessable patients, 17 (33%) achieved a complete response (CR), 8 (16%) a marker-negative partial remission (PRm-), 5 (10%) a marker-positive partial remission, 5 (10%) stable disease, and 13 (25%) progressive disease. There were 3 toxic deaths (6%). With an overall median follow-up of 14 months (range 1-219), 7 of 9 (78%) patients with late intensification and 18 of the 25 patients (72%) achieving a CR/PRm- following HDC were free of relapse/progression. In total, 25 of 60 patients (42%) were progression-free following HDC at a median follow-up of 87 months (range 3-219 months). Conclusions: Salvage HDC based on carboplatin represents a therapeutic option for female patients with relapsed/refractory GCT

Analyser la restauration des petits marais littoraux : origine, montage et principaux apports du programme PEPPS

National audiencePour faire face aux impacts du changement climatique et relever le défi du déclin de la biodiversité, la question de la dépoldérisation des petits marais littoraux est de plus en interrogée. C’est dans ce contexte qu’a été mené le programme de recherche « Pertinence environnementale de la restauration des petits marais et prés salés » (PEPPS, 2018-2021). Dans cet article, les auteurs présentent les objectifs et l’approche de ce programme. Ils font également le point des principaux apports en termes de connaissances sur les dynamiques et les processus de la restauration des petits marais salés tant des points de vue écologiques que sociaux

Characteristics of the participants according to CAD status.

<p>Characteristics of the participants according to CAD status.</p

Association between <i>APOE</i> genotypes and other cardio-metabolic risk factors.

<p>Association between <i>APOE</i> genotypes and other cardio-metabolic risk factors.</p

Association between APOE genotype, cardiovascular risk factors, and CAD.

<p>Association between APOE genotype, cardiovascular risk factors, and CAD.</p

Association between lipid levels and <i>APOE</i> genotypes in non-CAD subjects.

<p>Association between lipid levels and <i>APOE</i> genotypes in non-CAD subjects.</p

Association of <i>APOE</i> gene polymorphism with lipid profile and coronary artery disease in Afro-Caribbeans

<div><p>Objectives</p><p>Apolipoprotein E gene (<i>APOE</i>) polymorphism is associated with the lipid profile and cardio-vascular disease. However, these relationships vary between ethnic groups.</p><p>We evaluated, for the first time in an Afro-Caribbean population, the distribution of <i>APOE</i> polymorphisms and their associations with coronary artery disease (CAD), the lipid profile and other cardio-metabolic risk factors.</p><p>Methods</p><p>We studied 712 Afro-Caribbean subjects including 220 with documented CAD and 492 healthy subjects. TaqMan assays were performed to genotype rs7412 and rs429358, the two variants that determine the <i>APOE</i> alleles ε2, ε3 and ε4. The association between <i>APOE</i> genotype and the lipid profile was analysed by comparing ε2 carriers, ε3 homozygotes and ε4 carriers.</p><p>Results</p><p>The frequencies of ε2, ε3 and ε4 in the overall sample were 8%, 70% and 22%, respectively. CAD was not associated with <i>APOE</i> polymorphism. The total cholesterol level was higher in ε4 carriers compared with ε2 carriers: 5.07 vs 4.59 mmol/L (P = 0.016). The LDL-cholesterol level was lower in <i>APOE</i> ε2 carriers compared with ε3 homozygotes and ε4 carriers: 2.65 vs 3.03 and 3.17 mmol/L, respectively (p = 0.002). The total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol ratios were similar in the three allelic groups. <i>APOE</i> polymorphism was not associated with diabetes, hypertension, waist circumference or body mass index.</p><p>Conclusions</p><p>Our results indicate that <i>APOE</i> gene polymorphism is associated with the lipid profile but not with CAD in Afro-Caribbean people. This lack of association with CAD may be explained by the low atherogenic profile observed in ε4 carriers, which may warrant further investigation.</p></div