Humoral immune depression following autologous stem cell transplantation is a marker of prolonged response duration in patients with mantle cell lymphoma

Rituximab maintenance (RM) after autologous stem cell transplantation (ASCT) is standard-of-care for young patients with mantle cell lymphoma (MCL). RM may enhance post-transplantation immune depression and risk of infections. We compared infection incidence and immune consequences of RM versus observation in transplanted MCL patients. All randomized patients included in the LyMa trial were eligible. The following parameters were collected prospectively: occurrence of fever, infection, hospitalization, neutropenia, hypogammaglobulinemia, CD4 lymphopenia and γ globulin (Ig) substitution. The post-ASCT period was divided into four periods in order to assess the possible effects of RM or ASCT on immune status. Each arm included 120 patients. Concerning infection incidence and all biological parameters, there was no difference between the two arms during the first year post ASCT. After this period, RM patients were more exposed to fever (P=0.03), infections (P=0.001), hypogammaglobulinemia (P=0.0001) and Ig substitution (P<0.0001). Incidences of hospitalization, neutropenia and CD4 lymphopenia were not different between the two arms. The number of rituximab injections was correlated with infections and hypogammaglobulinemia, P<0.0001 and P=0.001; but was not correlated with neutropenia and CD4 lymphopenia. Ig substitution did not modify infection incidence. Patients who presented hypogammaglobulinemia <6 g/L or <4 g/L had longer 3-years progression-free survival (PFS), this applies to RM patients (P=0.012 and P=0.03) and to the global cohort (P=0.008 and P=0.003). Hypogammaglobulinemia did not influence overall survival. Occurrence of infectious event, neutropenia and CD4 lymphopenia did neither influence PFS nor overall survival. Post-ASCT RM in MCL patients causes sustained hypogammaglobulinemia, which is independently correlated with improved PFS

Complete Set of Elastic Moduli of a Spin-Crossover Solid: Spin-State Dependence and Mechanical Actuation

Molecular spin crossover complexes are promising candidates for mechanical actuation purposes. The relationships between their crystal structure and mechanical properties remain, however, not well understood. In this study, combining high pressure synchrotron Xray diffraction and nuclear inelastic scattering measurements, we assessed the effective macroscopic bulk modulus (11.5 ± 2.0 GPa), Young’s modulus (10.9 ± 1.0 GPa) and Poisson’s ratio (0.34 ± 0.04) of the spin crossover complex [FeII(HB(tz)3)2] (tz = 1,2,4-triazol-1-yl) in its low spin state. Crystal structure analysis revealed a pronounced anisotropy of the lattice compressibility, which was correlated with the difference in spacing between the molecules in different crystallographic directions. Switching the molecules from the low spin to the high spin state leads to a remarkable drop of the Young’s modulus to 7.1 ± 0.5 GPa, which was also assessed in thin film samples by means of micromechanical measurements. These results are in agreement with the high cooperativity of the spin crossover in this compound and highlight its application potential in terms of recoverable stress (21 ± 1 MPa) and work density (15 ± 6 mJ/cm3)

Etude de la faisabilité de l'allogreffe de cellules souches hématopoïétiques dans la myélofibrose primitive ou secondaire à un autre syndrome myéloprolifératif

L'objectif était d'étudier la faisabilité de l'allogreffe de cellules souches hématopoïétiques (CSH) à conditionnement myéloablatif ou d'intensité réduite dans le cas de la myélofibrose primitive ou secondaire à une polyglobulie ou à une thrombocytémie essentielles. 39 patients avec un âge médian de 49 ans (15-65) et allogreffés entre 1994 et 2008 ont été inclus dans notre étude rétrospective multicentrique. Le score de Dupriez était bas pour 9, intermédiaire pour 16 et élevé pour 14 patients, 10 étaient en phase acutisée. 15 patients ont reçu un conditionnement myéloablatif (CMA) et 24 un conditionnement d'intensité réduite (CIR). Le donneur était apparenté pour 25 patients et tous ont reçu un greffon HLA-matched (>= 9/10). La sortie d'aplasie a été effective chez tous les patients sauf un, avec une médiane de 15 jours [0-129] post greffe. Celle-ci a été plus rapide chez les patients splénectomisés ou ayant reçu un conditionnement de type CIR. 79% des patients ont développé une GVHD aigue de grade I à IV. Sur les 35 patients évaluables, 18 ont développé une GVHD chronique. La survie globale et la survie sans rechute à 3 ans étaient de 61 et 55% respectivement. La mortalité reliée au traitement (TRM) à 3 ans était de 28%. Il n'y avait aucune différence significative entre les groupes CMA et CIR en terme de survie globale ou TRM. Une thrombopénie < 100000/mm3 était associée à une survie globale inférieure (p=0.011). Notre étude confirme le potentiel curatif de l'allogreffe de CSH de type CMA ou CIR dans la myélofibrose, cependant au prix d'une TRM importante. Dans le groupe CIR, celle-ci était liée au délai trop important entre le diagnostic et la greffe qui va de paire avec un stade plus avancé de la maladie. Nous recommandons plutôt un conditionnement de type non myéloablatif pour les patients ayant un stade intermédiaire, quelque soit leur âge (jusqu'à 65 ans). Une splénectomie avant greffe ne doit pas être systématique. Les patients thrombopéniques (plaquettes < 100000/mm3) ne sont pas de bons candidats à l'allogreffe de CSH.CLERMONT FD-BCIU-Santé (631132104) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Hypogammaglobulinemia during Rituximab Maintenance after Transplantation Is a Surrogate Marker for Disease Control in Patients with Mantle-Cell Lymphoma, an Analysis from the LyMa Trial

International audienceHypogammaglobulinemia during Rituximab Maintenance after Transplantation Is a Surrogate Marker for Disease Control in Patients with Mantle-Cell Lymphoma, an Analysis from the LyMa Tria

Satisfaction of Cancer Patients Treated with Oral Anticancer Medications regarding Dispensing by Community Pharmacists: A Cross-Sectional Study

Purpose. The growing choice of oral anticancer medications (OAMs) delivered in pharmacies puts the patients at the center of their own therapeutic management. Patient satisfaction regarding their pharmaceutical management is particularly important for adherence to their treatment. The aim of this study was to assess the satisfaction of patients treated with OAMs regarding their dispensing in community pharmacies. Methods. A cross-sectional study was conducted with a self-questionnaire proposed to patients in hospital centers and community pharmacies. The patient’s satisfaction regarding pharmacy dispensing was assessed with a visual analogue scale. Answers to questions about the quality of information they received from health professionals were recorded. The patient’s adherence to their medication was assessed with the 8-item Morisky Medication Adherence Scale (MMAS-8). Symptoms and quality of life were recorded with the QLQ-C30 questionnaire. Results. Ninety-one patients were included in the analysis. The median score of satisfaction was 89 (interquartile range: 68, 100), and 49.5% had a satisfaction score ≥90/100. Satisfaction scores were higher for patients reporting information from pharmacists for the method of administration, the management of adverse effects, and drug interactions than for patients reporting no information from pharmacists. Patient satisfaction was not related to MMAS-8 scores, symptoms, or quality of life. Multivariate analysis of patient satisfaction revealed a positive relationship with information on the administration method provided by pharmacists. Conclusions. The level of information provided on OAMs to patients should be the same between pharmacists and oncologists. Good medication dispensing practices by the pharmacist are important components of patient care and satisfaction. We encourage pharmacists to provide more medication information to their patients

Human herpesvirus 6 infection after autologous stem cell transplantation: A multicenter prospective study in adult patients

International audienc

Prevention of Venous Thrombotic Events in Adult Patients with Acute Lymphoblastic Leukemia Treated in a Pediatric-Inspired Protocol - a Graall Study

58th Annual Meeting and Exposition of the American-Society-of-Hematology (ASH), San Diego, CA, DEC 03-06, 2016International audienc