Réhabiliter le pisé: vers des pratiques adaptées

International audienceLa demande des professionnels et des particuliers pour de l’information fiable sur le pisé croit avec l’engouement que connaît l’écoconstruction. Un grand espoir est placé dans cette terre qui jouit déjà d’une place privilégiée parmi les "matériaux d’avenir".Cet ouvrage veut combler le manque d’information sur l’utilisation de cette technique de construction en replaçant le pisé dans son contexte historique et culturel, en analysant la technique de mise en œuvre et ses évolutions récentes, en donnant les clés pour diagnostiquer son bâtiment, l’entretenir ou le réhabilite

Allogeneic hematopoietic cell transplantation in patients with therapy-related myeloid neoplasm after breast cancer: a study of the Chronic Malignancies Working Party of the EBMT

We performed a registry study on therapy-related myeloid neoplasm (t-MN), both therapy-related myelodysplastic syndrome (t-MDS) and acute myeloid leukemia (t-AML) following treatment for breast cancer who underwent a first allogeneic hematopoietic cell transplant (allo-HCT). Of 252 identified female patients (median age 57 years), 77% were transplanted for t-AML and 23% for t-MDS, with a median time from breast cancer diagnosis to the diagnosis of tMN and subsequent allo-HCT of 3.7 and 4.6 years, respectively. At transplant, 191 patients were in remission for breast cancer, while 4 were not (57 missing). T-MN was in a complete remission at the time of transplant in 67% of patients. 2-year overall survival, relapse free-survival, relapse incidence and non-relapse mortality were 50%, 45%, 33%, and 22%, respectively. Multivariable analysis revealed that if the t-MN was not in CR pre-transplant, this was associated with lower OS, RFS, and a higher relapse incidence. Seventeen cases of breast cancer recurrence were recorded after a median of 2.4 years post-transplant, and relapse of primary breast cancer accounted for 7% of deaths. This study indicates that allo-HCT for t-MN following treatment for breast cancer shows encouraging transplant outcomes. The incidence of breast cancer relapse post-transplant remains a cause for concern

Outcomes of Allogeneic Hematopoietic Cell Transplantation (allo-HCT) for Adults with Primary Mediastinal B Cells Lymphoma (PMBCL): A Retrospective Study on Behalf of the Société Francophone De Greffe De Moelle Et De Thérapie Cellulaire (SFGM-TC) and the Lymphoma Study Association (LYSA) Group

Abstract Introduction: Primary mediastinal B cells lymphoma (PMBCL) is a rare subtype of aggressive non Hodgkin lymphoma (NHL). Despite therapeutic progresses, 10 to 30% of PMBCL patients are primary refractory or experience early relapses (R/R). Despite Autologous hematopoietic cell transplantation (auto-HCT) after bridging therapy or new therapies such as PD-1 inhibitors or CAR-T cells, R/R PMBL patients have a very poor outcome. Allogeneic stem cell transplantation (allo-HCT) is thus a potentially curative treatment for patients who relapsed after salvage therapies. Only limited data have been published about allo-SCT in R/R PMBCL (Herrera A. F, BBMT 2019). In the present study conducted on behalf the Société Francophone de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC) and the lymphoma study association (LYSA) group, we investigated the outcomes of allo-transplanted adult R/R PMBCL. Methods This multicenter retrospective study included all adult R/R PMBCL patients reported to the SFGM-TC and who underwent an allo-HCT between 1999 and 2018. Data have been obtained through ProMISe (internet-based system shared by all European transplantation centers) and completed by consulting the medical files of the LYSA group centers. All patients have given signed informed consent. Results Thirty-three patients with R/R PMBCL from 19 French (n=29) and 3 Belgium (n=4) centers were included. The median age at transplant was 33 y (18-61), with a predominance of female patients (58%). Majority of patients had a low HCT-CI score [0 = 9/17 (53%), data missing in 16 patients]. Seventy-six percent of patients had an IPI score between 1 and 2 and Ann Harbor score was ≥ 3 in 56.6% at diagnosis. Median number of treatment lines before allo-HCT was 3 (1-6). All patients received poly-chemotherapies with anthracyclines and anti-CD20 as first-line therapy. Most sixty-one percent of patients had previously undergone auto-HCT and one patient received CAR-T before allo-HCT. Forty one percent of patients were primary refractory. At time of transplant, 50% of patients were in complete response, 40% in partial response, and 10% had a progressive disease. Conditioning regimen was reduced intensity regimen in 63%. Stem cell source was PBSC in 88%. Donors were sibling in 42% or matched related donor in 39%. An alternative donor was chosen in 18%. GVHD prophylaxis included antithymocyte globulin in 61%, and calcineurin inhibitor in 97%. Median follow up was 78 months (3.5-157). Considering the whole cohort, 2y OS, DFS, NRM, and cumulative incidence of relapse were 48% (95%CI: 33-70), 60% (95%CI: 44-82), 18% (95%CI: 7-34), and 34% (95%CI: 18-50) respectively. Cumulative incidences of day 100 grade I-II and III-IV acute GVHD 36% and 0%, respectively. Cumulative incidence was 32% among whom 33% had an extensive cGVHD. Patients with progressive disease at transplantation had worst 2y PFS and OS (PFS: HR: 6.12, 95%CI: 1.32-28.31, p=0.02 and OS: HR: 7.04, 95%CI: 1.52-32.75, p=0.013). Conclusion: To our knowledge, this is the largest published study evaluating outcomes of allo-HCT for R/R PMBCL. Although this is a retrospective study with a limited number of patients, the outcomes suggest that allo-HCT is a therapeutic option providing durable remissions for patients with R/R PMBCL. Introduction: Primary mediastinal B cells lymphoma (PMBCL) is a rare subtype of aggressive non Hodgkin lymphoma (NHL). Despite therapeutic progresses, 10 to 30% of PMBCL patients are primary refractory or experience early relapses (R/R). Despite Autologous hematopoietic cell transplantation (auto-HCT) after bridging therapy or new therapies such as PD-1 inhibitors or CAR-T cells, R/R PMBL patients have a very poor outcome. Allogeneic stem cell transplantation (allo-HCT) is thus a potentially curative treatment for patients who relapsed after salvage therapies. Only limited data have been published about allo-SCT in R/R PMBCL (Herrera A. F, BBMT 2019). In the present study conducted on behalf the Société Francophone de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC) and the lymphoma study association (LYSA) group, we investigated the outcomes of allo-transplanted adult R/R PMBCL. Methods This multicenter retrospective study included all adult R/R PMBCL patients reported to the SFGM-TC and who underwent an allo-HCT between 1999 and 2018. Data have been obtained through ProMISe (internet-based system shared by all European transplantation centers) and completed by consulting the medical files of the LYSA group centers. All patients have given signed informed consent. Results Thirty-three patients with R/R PMBCL from 19 French (n=29) and 3 Belgium (n=4) centers were included. The median age at transplant was 33 y (18-61), with a predominance of female patients (58%). Majority of patients had a low HCT-CI score [0 = 9/17 (53%), data missing in 16 patients]. Seventy-six percent of patients had an IPI score between 1 and 2 and Ann Harbor score was ≥ 3 in 56.6% at diagnosis. Median number of treatment lines before allo-HCT was 3 (1-6). All patients received poly-chemotherapies with anthracyclines and anti-CD20 as first-line therapy. Most sixty-one percent of patients had previously undergone auto-HCT and one patient received CAR-T before allo-HCT. Forty one percent of patients were primary refractory. At time of transplant, 50% of patients were in complete response, 40% in partial response, and 10% had a progressive disease. Conditioning regimen was reduced intensity regimen in 63%. Stem cell source was PBSC in 88%. Donors were sibling in 42% or matched related donor in 39%. An alternative donor was chosen in 18%. GVHD prophylaxis included antithymocyte globulin in 61%, and calcineurin inhibitor in 97%. Median follow up was 78 months (3.5-157). Considering the whole cohort, 2y OS, DFS, NRM, and cumulative incidence of relapse were 48% (95%CI: 33-70), 60% (95%CI: 44-82), 18% (95%CI: 7-34), and 34% (95%CI: 18-50) respectively. Cumulative incidences of day 100 grade I-II and III-IV acute GVHD 36% and 0%, respectively. Cumulative incidence was 32% among whom 33% had an extensive cGVHD. Patients with progressive disease at transplantation had worst 2y PFS and OS (PFS: HR: 6.12, 95%CI: 1.32-28.31, p=0.02 and OS: HR: 7.04, 95%CI: 1.52-32.75, p=0.013). Conclusion: To our knowledge, this is the largest published study evaluating outcomes of allo-HCT for R/R PMBCL. Although this is a retrospective study with a limited number of patients, the outcomes suggest that allo-HCT is a therapeutic option providing durable remissions for patients with R/R PMBCL. Disclosures Sibon: Abbvie: Consultancy; Takeda: Consultancy; iQone: Consultancy; Roche: Consultancy; Janssen: Consultancy. Loschi: AbbVie: Ended employment in the past 24 months, Honoraria; CELGENE/BMS: Honoraria; Gilead: Ended employment in the past 24 months, Honoraria; Novartis: Ended employment in the past 24 months, Honoraria; Servier: Ended employment in the past 24 months, Honoraria; MSD: Honoraria. Dulery: Novartis: Honoraria; Takeda: Consultancy; Gilead: Other: Travel support and registration fees for scientific meetings . </jats:sec

LES PRINCIPAUX RÉSULTATS SCIENTIFIQUES DU DÉMONSTRATEUR SMART ELECTRIC LYON

Les résultats présentés dans ce document concernent les terrains sur lesquels le projet Smart Electric Lyon s’est déployé, à savoir, des bâtiments existants. Ces bâtiments appartiennent au secteur Résidentiel et à celui du Tertiaire et des Collectivités locales. Les participants à l’expérimentation (les clients) sont dans une démarche d’amélioration de leurs pratiques énergétiques. Rappelons que la maîtrise de la demande en électricité (MDE) est associée à une diminution de consommation d’énergie alors que la flexibilité l’est à une variation de la puissance (active ou réactive) en réponse à une sollicitation ponctuelle et contractualisée. Plus simplement, du point du vue du consommateur, la MDE a des conséquences immédiates et locales tandis que l’impact de la flexibilité ne se mesure qu’au niveau de l’ensemble du système électrique. Ceci peut entraîner des logiques différentes de la part des clients en termes de motivations et d’actions. La feuille de route du projet Smart Electric Lyon s’articule bien autour de la question de la flexibilité. L’expérimentation imaginée pour traiter cette question consiste à utiliser le compteur communicant Linky associé à des équipements connectés de partenaires industriels - équipements d’affichage des consommations et de pilotage des appareils électriques - principalement sur le chauffage électrique, pour réaliser des effacements pendant la pointe de demande journalière en électricité, sur les jours de l’année les plus critiques (22 jours froids par an, entre 18h et 20h). Pour les clients - les particuliers, les entreprises, les collectivités - Smart Electric Lyon permet d’améliorer la qualité des produits et services, qui peuvent leur être proposés pour réduire leur consommation énergétique tout en maintenant leur niveau de confort et de productivité

LES PRINCIPAUX RÉSULTATS SCIENTIFIQUES DU DÉMONSTRATEUR SMART ELECTRIC LYON

Les résultats présentés dans ce document concernent les terrains sur lesquels le projet Smart Electric Lyon s’est déployé, à savoir, des bâtiments existants. Ces bâtiments appartiennent au secteur Résidentiel et à celui du Tertiaire et des Collectivités locales. Les participants à l’expérimentation (les clients) sont dans une démarche d’amélioration de leurs pratiques énergétiques. Rappelons que la maîtrise de la demande en électricité (MDE) est associée à une diminution de consommation d’énergie alors que la flexibilité l’est à une variation de la puissance (active ou réactive) en réponse à une sollicitation ponctuelle et contractualisée. Plus simplement, du point du vue du consommateur, la MDE a des conséquences immédiates et locales tandis que l’impact de la flexibilité ne se mesure qu’au niveau de l’ensemble du système électrique. Ceci peut entraîner des logiques différentes de la part des clients en termes de motivations et d’actions. La feuille de route du projet Smart Electric Lyon s’articule bien autour de la question de la flexibilité. L’expérimentation imaginée pour traiter cette question consiste à utiliser le compteur communicant Linky associé à des équipements connectés de partenaires industriels - équipements d’affichage des consommations et de pilotage des appareils électriques - principalement sur le chauffage électrique, pour réaliser des effacements pendant la pointe de demande journalière en électricité, sur les jours de l’année les plus critiques (22 jours froids par an, entre 18h et 20h). Pour les clients - les particuliers, les entreprises, les collectivités - Smart Electric Lyon permet d’améliorer la qualité des produits et services, qui peuvent leur être proposés pour réduire leur consommation énergétique tout en maintenant leur niveau de confort et de productivité