RADIOLOGICAL AND PATHOLOGICAL RESPONSE TO NEOADJUVANT NIVOLUMAB IN PATIENTS WITH BCLC A HCC TREATED BY CURATIVE PERCUTANEOUS IRREVERSIBLE ELECTROPORATION: PRELIMINARY REPORT FROM THE FRENCH MULTICENTRE PHASE 2 NIVOLEP TRIAL.

International audienc

RADIOLOGICAL AND PATHOLOGICAL RESPONSE TO NEOADJUVANT NIVOLUMAB IN PATIENTS WITH BCLC A HCC TREATED BY CURATIVE PERCUTANEOUS IRREVERSIBLE ELECTROPORATION: PRELIMINARY REPORT FROM THE FRENCH MULTICENTRE PHASE 2 NIVOLEP TRIAL.

International audienc

RADIOLOGICAL AND PATHOLOGICAL RESPONSE TO NEOADJUVANT NIVOLUMAB IN PATIENTS WITH BCLC A HCC TREATED BY CURATIVE PERCUTANEOUS IRREVERSIBLE ELECTROPORATION: PRELIMINARY REPORT FROM THE FRENCH MULTICENTRE PHASE 2 NIVOLEP TRIAL.

International audienc

Severe Viral Hepatitis in a Patient with Chronic Lymphocytic Leukemia (CLL) Complicated with Autoimmune Haemolytic Anemia (AIAH), Treated with Steroids

International audienceInfectious complications are a major cause of morbidity and mortality in patients with chronic lymphocytic leukemia (CLL) due to impaired immunity secondary to the disease itself and to the immunosuppressive therapies administered to these patients. We report a 78-year-old woman with CLL who was treated with steroids for autoimmune hemolytic anemia (AIHA). A few weeks later, she was admitted for severe acute hepatitis with disseminated intravascular coagulation (DIC). Despite the symptomatic treatment of DIC, standard reanimation and probabilistic antibiotics, the patient died within 24h with severe hepatic failure. Autopsy was in favor of a disseminated viral infection with esophageal, hepatic and pulmonary cytopathologic lesions with acidophilic intranuclear inclusions suggestive of herpes virus, even though HSV 1 and 2, CMV and HHV6 PCRs were negative. This case of severe viral hepatitis with esophagitis occurring three weeks after the introduction of high-dose steroid treatment for AIHA in a CLL patient calls for anti-herpetic prophylaxis in such patients, immunodepressed by their diseases and the treatment they receive

Transient Elastography Accurately Screens for Compensated Advanced Chronic Liver Disease in Patients with Ongoing or Recent Alcohol Withdrawal

International audienceBACKGROUND AND AIMS: Liver stiffness measurement by transient elastography (TE) is a promising method for staging fibrosis in alcohol-related liver disease, but uncertainties remain regarding the influence of alcohol consumption and thus the ideal timing for TE performance. We evaluated the performance of TE compared with liver biopsy to exclude compensated advanced chronic liver disease (cACLD) in patients hospitalized for alcohol detoxification. METHODS: Patients were prospectively recruited at six in-patient addiction centers in France. Eligible patients exhibited increased aspartate-amino-transferases, and no history or signs of overt cirrhosis. TE, histology, and biochemistry measurements were obtained within a median of 6 days after alcohol withdrawal. TE and biochemistry were repeated one and two months later. RESULTS: The study included 259 patients for per-protocol analysis, of whom 45 (17.4%) had cACLD. TE identified patients with high accuracy at inclusion, 1-, and 2-month follow up, with area under curve values of 0.96 [95% confidence interval, CI, 0.94-0.99], 0.96 [95% CI, 0.92-0.99], and 0.93 [95% CI, 0.85-1.00], respectively. In 84% of patients, cACLD was ruled out when liver stiffness was <10 kPa (negative predictive value, 99% [98-100%]) or ruled in when >25 kPa (positive predictive value, 93% [83-102%]). Algorithms based on transaminases and/or bilirubin did not add to diagnostic performance of TE in this period. Among patients with initial liver stiffness of 10-25 kPa, over half of those with no cACLD exhibited liver stiffness of <10 at 1- and 2 month follow-up testing. CONCLUSIONS: Transient elastography performed during the first two months following alcohol cessation is an excellent method for excluding alcohol-related cACLD

Drivers of outcome in compensated alcohol-related cirrhosis: a prospective study

International audienc