Publications by authors named "Aurelien Giltat"

High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is part of the treatment strategy for some patients with high-risk lymphoma by improving survival with an acceptable toxicity profile. Although the BEAM (BCNU, etoposide, cytarabine, and melphalan) intensification regimen is the most used, the optimal dosing for each drug is unclear. Here, we retrospectively compared the outcome of 110 patients receiving higher (400 mg/m, n = 69) or lower (200 mg/m, n = 41) etoposide and cytarabine doses in our institution between 2012 and 2019.

View Article and Find Full Text PDF
Article Synopsis
  • * Researchers analyzed 91 patients and found multiple gene mutations, with FLT3 and NPM1 being the most common; specific mutations were linked to remission success, treatment resistance, and post-relapse mortality.
  • * Short-term outcomes were best predicted by general health and performance status, while long-term outcomes were better assessed using genomic classifications, highlighting the need for tailored prognostic systems for older patients, as existing models primarily focus on younger individuals.
View Article and Find Full Text PDF

Background: Recently, the combination of venetoclax plus a hypomethylating agent (HMA; azacitidine ordecitabine) or low-dose cytarabine (LDAC) showed promise in Phase III trials in previously untreated AML. In France at the time of this study, venetoclax was not yet approved for AML and there were therefore no formal usage recommendations. Here we report the first study in a French cohort that assessed venetoclax in combination with existing treatments for AML under real-life conditions.

View Article and Find Full Text PDF
Article Synopsis
  • - The article defines and discusses three key complications after hematopoietic cell transplantation (HCT): graft failure, poor graft function, and erythroblastopenia, highlighting the associated risk factors and treatment guidelines.
  • - Graft failure is a severe but rare complication, while poor graft function occurs more frequently; new research is anticipated to validate current treatment recommendations for these issues.
  • - Erythroblastopenia is another rare complication post-HCT, and even with improved donor-recipient compatibility, some patients still experience this problem.
View Article and Find Full Text PDF

Progressive multifocal leukoencephalopathy (PML) is a fatal demyelinating disease of the central nervous system resulting from the reactivation of the John Cunningham virus (JCV). PML occurs almost exclusively during profound immune suppression but it can also be observed in immunocompromised subjects as part of an inflammatory immune reconstitution syndrome (IRIS) in patients receiving antiviral therapy. We report a case of PML in a 61-year-old patient with acute myeloid leukemia who had developed after discontinuation of durvalumab (anti-PD-L1) therapy initiated after multiple treatments.

View Article and Find Full Text PDF
Article Synopsis
  • Daunorubicin pharmacokinetics (PK) show significant variability among individuals, complicating dosage determination in acute myeloid leukemia patients.
  • The study involved 14 participants, collecting multiple blood samples after administering a fixed dose of daunorubicin, and utilized advanced chromatography techniques for drug quantification.
  • Analysis revealed key pharmacokinetic metrics and suggested an optimal design for future population PK studies, considering factors like body surface area and plasma creatinine levels.
View Article and Find Full Text PDF

Background: Three different scoring systems have been developed to assess pre-transplant comorbidity in allogeneic hematopoietic stem cell transplantation (Allo-HSCT): the Hematopoietic Cell Transplantation-Specific Comorbidity Index, the Comorbidity/Age index, and the Augmented Comorbidity/Age index. All were devised to predict overall survival (OS) and disease-free survival (DFS) survivals and non-relapse mortality (NRM) in patients receiving HLA-matched Allo-HSCT, but their performance has scarcely been studied in the haploidentical Allo-HSCT setting with post-transplant cyclophosphamide, a procedure in constant expansion worldwide.

Methods: To address this issue, their impact on survivals and NRM was examined in a cohort of 223 patients treated with haploidentical Allo-HSCT in four different centers.

View Article and Find Full Text PDF

The negative impact of high serum ferritin level (SFL) before and after allogeneic hematopoietic cell transplantation (allo-HSCT) on outcomes is well recognized. However, it is poorly documented in adults undergoing haploidentical HSCT (haplo-HSCT) with post-transplantation cyclophosphamide (PTCY) for hematologic malignancies. The main objective was to assess the impact of pretransplantation and post-transplantation SFL on overall survival (OS), disease-free survival (DFS), and nonrelapse mortality (NRM) in patients undergoing haplo-HSCT with PTCY.

View Article and Find Full Text PDF
Article Synopsis
  • Immunoglobulin replacement therapy is often recommended for severe hypogammaglobulinemia in patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT), but its link to increased infection risk remains unconfirmed.
  • A study involving 76 allo-HSCT patients found no significant difference in gamma globulin levels between those who had infections and those who did not during the first 100 days post-transplant.
  • The findings suggest that humoral deficiency has a limited role in immune deficiency during this period, raising questions about the necessity of immunoglobulin replacement therapy.
View Article and Find Full Text PDF
Article Synopsis
  • High-risk patients with acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS) often relapse after allogeneic stem cell transplants, prompting the study of post-transplant maintenance therapies like low-dose azacitidine (AZA) and donor lymphocyte infusion (DLI).
  • A retrospective analysis of 77 high-risk AML/MDS patients who underwent maintenance therapy showed that 47% completed 12 cycles of AZA and 79% received at least one DLI, with a 25% relapse rate observed within 24 months.
  • The study reported overall survival and progression-free survival rates at 24 months of 70.8% and 68.3%, respectively, along with incidence
View Article and Find Full Text PDF

Diffuse large B-cell lymphoma (DLBCL) with extra nodal skeletal involvement is rare. It is currently unclear whether these lymphomas should be treated in the same manner as those without skeletal involvement. We retrospectively analyzed the impact of combining high-dose methotrexate (HD-MTX) with an anthracycline-based regimen and rituximab as first-line treatment in a cohort of 93 patients with DLBCL and skeletal involvement with long follow-up.

View Article and Find Full Text PDF
Article Synopsis
  • Idelalisib is a targeted cancer treatment for B cell malignancies, approved since 2014, but now raises concerns about serious pulmonary side effects.
  • Five out of 16 patients in a study experienced severe pulmonary adverse events, primarily linked to pneumonia and drug-induced pneumonitis.
  • The cause of these complications is unclear but may relate to idelalisib's inhibition of both PI3Kδ and the mTOR pathway, necessitating careful monitoring and possible corticosteroid treatment for affected patients.
View Article and Find Full Text PDF

Delayed onset haemolysis occurring post-artesunate and post-artemisinin combination therapy is secondary to delayed clearance of infected erythrocytes spared by pitting during treatment. We report a case of severe post-treatment delayed haemolytic anaemia with a positive direct antiglobulin test and a positive response to corticosteroid therapy, suggesting an associated immune mechanism.

View Article and Find Full Text PDF

Plasma cell infiltration of the liver has been described in about 45% of patient with multiple myeloma in autopsy review; however, it is usually not associated with significant liver dysfunction. Indeed, only rare cases of massive plasma cell infiltration leading to non-obstructive cholestasis and hepatic failure have been described. Here, we report a case with a history of 8 years of MM with extensive liver fibrosis and portal hypertension with no other evidence aetiology unless massive plasma cell infiltration who presented a significant regression of both biological liver abnormalities and liver stiffness after ten months of chemotherapy concomitantly to a significant decrease of the IgG serum monoclonal band.

View Article and Find Full Text PDF