78 research outputs found

    Late relapse after hematopoietic stem cell transplantation for acute leukemia: a retrospective study by SFGM-TC.

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    peer reviewedLate relapse (LR) after allogeneic hematopoietic stem cell transplantation (AHSCT) for acute leukemia is a rare event (nearly 4.5%) and raises the questions of prognosis and outcome after salvage therapy. We performed a retrospective multicentric study between January 1, 2010, and December 31, 2016, using data from the French national retrospective register ProMISe provided by the SFGM-TC (French Society for Bone Marrow Transplantation and Cellular Therapy). We included patients presenting with LR, defined as a relapse occurring at least 2 years after AHSCT. We used the Cox model to identify prognosis factors associated with LR. During the study period, a total of 7582 AHSCTs were performed in 29 centers, and 33.8% of patients relapsed. Among them, 319 (12.4%) were considered to have LR, representing an incidence of 4.2% for the entire cohort. The full dataset was available for 290 patients, including 250 (86.2%) with acute myeloid leukemia and 40 (13.8%) with acute lymphoid leukemia. The median interval from AHSCT to LR was 38.2 months (interquartile range [IQR], 29.2 to 49.7 months), and 27.2% of the patients had extramedullary involvement at LR (17.2% exclusively and 10% associated with medullary involvement). One-third of the patients had persistent full donor chimerism at LR. Median overall survival (OS) after LR was 19.9 months (IQR, 5.6 to 46.4 months). The most common salvage therapy was induction regimen (55.5%), with complete remission (CR) obtained in 50.7% of cases. Ninety-four patients (38.5%) underwent a second AHSCT, with a median OS of 20.4 months (IQR, 7.1 to 49.1 months). Nonrelapse mortality after second AHSCT was 18.2%. The Cox model identified the following factors as associated with delay of LR: disease status not in first CR at first HSCT (odds ratio [OR], 1.31; 95% confidence interval [CI], 1.04 to 1.64; P = .02) and the use of post-transplantation cyclophosphamide (OR, 2.23; 95% CI, 1.21 to 4.14; P = .01). Chronic GVHD appeared to be a protective factor (OR, .64; 95% CI, .42 to .96; P = .04). The prognosis of LR is better than in early relapse, with a median OS after LR of 19.9 months. Salvage therapy associated with a second AHSCT improves outcome and is feasible, without creating excess toxicity

    L’eau dans la ville. Une amie qui nous fait la guerre

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    International audienceL’eau est vitale pour les hommes. Mais la montée en puissance des villes complique les relations entre l’eau et l’homme. ­Rareté de la ressource, risque d’inondation, problèmes techno­logiques… L’eau, bien public, doit-elle être gérée par le public ? Trustée par de grandes entreprises privées ? Quid de l’eau dans les pays du Sud ? La gestion urbaine de l’eau est au cœur de nombreux débats – nationaux et internationaux –, car l’eau est un enjeu majeur, aussi bien du point de vue de la préservation de l’environnement que du bon fonctionnement du milieu urbain.Un essai documenté, précis, sur une question centrale trop souvent ignorée, qui fait comprendre la complexité du sujet et ­expose clairement les enjeux

    Analyse probabiliste régionale de la pluviométrie extrême en France métropolitaine

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    Regional probabilistic approach of extreme rainfall events in metropolitan France This paper summarises the results obtained by the SPEED method over the past 20 years to analyse rainfall in metropolitan France. Its original approach is in combining the probabilistic theory of Poisson’s process, regional analysis and the integration of particular phenomena combined with orographic features. After analysing numerous daily rainfall series, four main extreme rainfall classes were defined in France : oceanic flows, Mediterranean-type rainfall, high-altitude rainfall and thunderstorms, which may be observed individually or in combination (mixed populations). We will also show how outliers can be integrated into the probabilistic approach by analysing the physical phenomena involved and via a regional analysis of rainfall. Lastly, this method helps to reduce the uncertainties involved in estimating 100-year events.Cette communication synthétise les résultats obtenus par la méthode SPEED depuis 20 ans sur l’analyse du régime des précipitations en France métropolitaine. Son originalité tient à la combinaison de la théorie probabiliste du processus de Poisson, de son approche régionale et de l’intégration de phénomènes physiques particuliers liés à l’orographie. Le bilan de l’analyse de nombreuses séries de pluies journalières conduit à définir en France quatre régimes pluviométriques : flux océaniques, pluies méditerranéennes, pluies d’altitude et pluies d’orage qui peuvent être observés de manière pure ou combinée (populations mixtes). Nous montrons par ailleurs comment des horsains peuvent être intégrés dans cette approche probabiliste grâce à une analyse des phénomènes physiques entrant en jeu et à une synthèse régionale de la pluviométrie. Enfin cette méthode permet de mieux cerner les incertitudes liées à l’estimation des évènements centennaux dans des cas difficiles.Carré Jean-Claude, Cayla Olivier. Analyse probabiliste régionale de la pluviométrie extrême en France métropolitaine. In: Evénements extrêmes fluviaux et maritimes. Leurs variabilités spatiales et chronologiques dans l'ouest de l’Europe. 34èmes journées de l’hydraulique Paris, 1 et 2 février 2012. 2012

    Efficient gene targeting and foreign DNA removal by homologous recombination in the picoeukaryote Ostreococcus

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    With fewer than 8000 genes and a minimalist cellular organization, the green picoalga Ostreococcus tauri is one of the simplest photosynthetic eukaryotes. Ostreococcus tauri contains many plant-specific genes but exhibits a very low gene redundancy. The haploid genome is extremely dense with few repeated sequences and rare transposons. Thanks to the implementation of genetic transformation and vectors for inducible overexpression/knockdown this picoeukaryotic alga has emerged in recent years as a model organism for functional genomics analyses and systems biology. Here we report the development of an efficient gene targeting technique which we use to knock out the nitrate reductase and ferritin genes and to knock in a luciferase reporter in frame to the ferritin native protein. Furthermore, we show that the frequency of insertion by homologous recombination is greatly enhanced when the transgene is designed to replace an existing genomic insertion. We propose that a natural mechanism based on homologous recombination may operate to remove inserted DNA sequences from the genome

    Usefulness of a regional probabilistic approach to determining design discharges of hydropower plants in Albania

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    This paper presents the results obtained using the PARDES-flood method in Albania to determine discharges of hydropower plants. The first part of the method is a regional probabilistic approach to extreme rainfall. The second part is related to the determination of extreme maximum peak discharges thanks to two probabilistic relations between statistical quantiles. The original approach in the first part lies in combining the probabilistic theory of Poisson’s process, regional analysis and the integration of particular phenomena linked to orographic features. The rivers studied in Albania include the Vjosa, which flows through the southern part of the country. It has a total length of 272 km, 80 km of which are in Greece. In this geographical area we have 13 rainfall stations at our disposal (not counting the numerous stations available nearby) and seven discharge measurement stations with data covering the period 1951-1992. The regional analysis of rainfall across this catchment area revealed a homogeneous precipitation regime. The rainfall-runoff probabilistic correlation analyses confirmed the relations from the PARDES model and revealed saturation at a return period of 4 years

    La mort subite du sportif : une réalité à maitriser

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    Indications et limites de l'Ă©preuve d'effor
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