Publications by authors named "Bertrand Joly"
Article Synopsis
- CD38-targeting immunotherapy combined with lenalidomide and dexamethasone is the current best standard of care for newly diagnosed multiple myeloma patients who can't undergo transplants.
- A phase 3 study involving 270 patients tested the effectiveness of adding weekly bortezomib to this regimen, comparing the outcomes of the combination (Isa-VRd) against the standard (IsaRd).
- Results showed a significantly higher rate of minimal residual disease negativity at 18 months and better response rates in the Isa-VRd group, suggesting it could become the new standard of care for these patients.
Article Synopsis
- Posterior reversible encephalopathy syndrome (PRES) is a rare condition noted in myeloma patients, often linked to chemotherapy, particularly proteasome inhibitors and stem cell transplants.
- A study analyzed three myeloma patients with PRES alongside 13 other published cases, primarily affecting women, highlighting risk factors like hypertension, infection, or renal failure.
- Common symptoms include headache and seizures, but most patients recover quickly and don’t experience relapses, suggesting that better blood pressure management may help prevent PRES in these individuals.
Article Synopsis
- - The phase II trial assessed the effectiveness of the RiBVD treatment (rituximab, bendamustine, velcade, and dexamethasone) in patients over 65 with mantle cell lymphoma (MCL), which resulted in a median progression-free survival of 79 months and overall survival of 111 months.
- - TP53 mutation status and albumin levels were identified as significant prognostic factors, with TP53 mutations linked to a higher risk of shorter progression-free survival and overall survival in the analyzed patient population.
- - A scoring system combining TP53 mutation status and albumin levels allowed differentiation of patient outcomes, indicating varying survival rates based on the presence of these factors, thus enhancing prognostic assessments
Article Synopsis
- Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is an aggressive, rare form of T-cell lymphoma mainly found in Asia, with a clinical study conducted on 71 European patients showing a median age of 67 years.
- Most patients had gastrointestinal symptoms requiring emergency surgery, with around 40% diagnosed at stage IV, and tumors were classified into typical and atypical morphologies sharing similar immunophenotypic profiles.
- The study highlighted significant genetic alterations, including mutations in genes like MYC, STAT5B, and TP53, which are associated with poor survival outcomes and treatment resistance, indicating the high clinical risk of MEITL.
Article Synopsis
- Stage IIB Hodgkin lymphoma (HL) patients with certain risk factors have a poor prognosis and are treated either as limited or advanced stage, with differing clinical trials comparing these treatment approaches.
- A study involving 148 patients showed that baseline total metabolic tumor volume (TMTV) and responses after two cycles of chemotherapy significantly influenced progression-free survival rates, with a median follow-up of 4.1 years showing PFS rates around 88%.
- The findings suggest that both upfront ABVD plus radiation therapy and upfront escBEACOPP without radiotherapy yield similar outcomes in these high-risk patients, while TMTV can effectively stratify their risk at baseline.
Article Synopsis
- Discontinuing tyrosine kinase inhibitors in chronic phase chronic myeloid leukemia (CML) is feasible, but more research is needed on factors that predict recurrence after stopping treatment and the long-term effects of treatment-free remission (TFR).
- In a study updating data from the STIM2 trial, 199 patients were analyzed, showing a significant percentage (43.4%) achieved TFR at 5 years, but many experienced a loss of major molecular response over time.
- The timing of molecular recurrence varied, with most recurrences occurring within the first 6 months after stopping treatment, and certain factors such as treatment duration and molecular response levels were linked to recurrence within the first 24 months but not later.
Background: Chronic heart failure (CHF) is one of the most common causes of mortality in industrialized countries despite regular therapeutic advances. Numerous factors influence mortality in CHF patients, including nutritional status. It is known that malnutrition is a risk factor for mortality, whereas obesity may play a protective role, a phenomenon dubbed the "obesity paradox".
View Article and Find Full Text PDFPurpose: The AHL2011 study (ClinicalTrials.gov identifier: NCT01358747) demonstrated that a positron emission tomography (PET)-driven de-escalation strategy after two cycles of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) provides similar progression-free survival (PFS) and overall survival (OS) and reduces early toxicity compared with a nonmonitored standard treatment. Here, we report, with a prolonged follow-up, the final study results.
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- Prolonged Covid-19 poses significant challenges for patients with lymphoma or immune deficiencies, as shown in a study of 111 adults hospitalized in France during March-April 2020.
- The research found that factors like age over 70, having relapsed/refractory lymphoma, and recent treatment with anti-CD20 therapy are linked to longer hospital stays and higher mortality rates.
- The study highlights the need for tailored management and vaccination strategies for lymphoma patients during the pandemic, given that the 6-month overall survival rate following hospitalization was only 69%.
Long-term outcome of imatinib 400 mg compared to imatinib 600 mg or imatinib 400 mg daily in combination with cytarabine or pegylated interferon alpha 2a for chronic myeloid leukaemia: results from the French SPIRIT phase III randomised trial.
Leukemia
August 2021
Article Synopsis
- - The SPIRIT trial is a long-term study that compares the effectiveness of various treatments for chronic-phase chronic myeloid leukaemia (CML), involving 787 patients followed for an average of 13.5 years.
- - Overall and progression-free survival rates after 15 years were similar across four treatment groups, ranging from 80% to 87%, suggesting comparable effectiveness of different combinations.
- - The combination of imatinib with pegylated interferon alpha2a resulted in significantly better molecular response rates compared to imatinib alone, although toxicity led to treatment cessation for some patients.
Article Synopsis
- Patients with lymphoma are highly vulnerable to severe outcomes from Covid-19 due to their weakened immune systems caused by both the disease and its treatments.
- In a study of 89 lymphoma patients hospitalized for Covid-19, the median age was 67, with a significant portion having comorbidities; overall survival at 30 days post-admission was 71%.
- Key factors linked to increased mortality included being 70 years or older and having relapsed/refractory lymphoma, while younger patients without these risk factors showed survival rates similar to the general population.
Purpose: We report a multicenter controlled trial comparing renal recovery and tolerance profile of doublet versus triplet bortezomib-based regimens in patients with initial myeloma cast nephropathy (CN) and acute kidney injury (AKI) without need for dialysis.
Methods: After symptomatic measures and high-dose dexamethasone, patients were randomly assigned to receive bortezomib plus dexamethasone (BD), or BD plus cyclophosphamide (C-BD). In patients with < 50% reduction of serum free light chains (sFLCs) after 3 cycles, chemotherapy was reinforced with either cyclophosphamide (BD group) or thalidomide (C-BD group).
Article Synopsis
- - A study of 279 hairy-cell leukemia (HCL) patients revealed a median survival of 27 years and a median relapse-free survival of 11 years after first-line treatment with purine analogs (PNAs), mostly cladribine or pentostatin, followed over 10 years.
- - The incidence of relapse was 39% over 10 years, with second-line therapy achieving a median relapse-free survival of 7 years, regardless of whether the same or another PNA was used.
- - Among the patients, 68 second malignancies were identified, showing an increased risk for solid and hematological cancers; however, the use of PNAs was not linked to a higher risk of these additional cancers
Evaluation of Residual Disease and TKI Duration Are Critical Predictive Factors for Molecular Recurrence after Stopping Imatinib First-line in Chronic Phase CML Patients.
Clin Cancer Res
November 2019
Purpose: Tyrosine kinase inhibitor (TKI) discontinuation is an emerging goal in chronic myelogenous leukemia (CML) management and several studies have demonstrated the feasibility of safely stopping imatinib. A sustained deep molecular response on long-term TKI is critical prior to attempting treatment-free remission. Reproducible results from several studies reported recently, failed to identify robust and reproducible predictive factors for the selection of the best candidates for successful TKI cessation.
View Article and Find Full Text PDFBackground: Increased-dose bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) improves progression-free survival in patients with advanced Hodgkin lymphoma compared with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD), but is associated with increased risks of haematological toxicity, secondary myelodysplasia or leukaemia, and infertility. We investigated whether PET monitoring during treatment could allow dose de-escalation by switching regimen (BEACOPP to ABVD) in early responders without loss of disease control compared with standard treatment without PET monitoring.
Methods: AHL2011 is a randomised, non-inferiority, phase 3 study done in 90 centres across Belgium and France.
We present results of a prospective, multicenter, phase II study evaluating rituximab, bendamustine, bortezomib and dexamethasone as first-line treatment for patients with mantle cell lymphoma aged 65 years or older. A total of 74 patients were enrolled (median age, 73 years). Patients received a maximum of six cycles of treatment at 28-day intervals.
View Article and Find Full Text PDFImportance: Cast nephropathy is the main cause of acute kidney injury in multiple myeloma and persistent reduction in kidney function strongly affects prognosis. Strategies to rapidly remove nephrotoxic serum-free light chains combined with novel antimyeloma agents have not been evaluated prospectively.
Objective: To compare the hemodialysis independence rate among patients newly diagnosed with myeloma cast nephropathy treated with hemodialysis using a high-cutoff dialyzer (with very large membrane pores and high permeability to immunoglobulin light chains) or a conventional high-flux dialyzer (with small pores and lower permeability).
Introduction: The aim of this study was to identify factors associated with the results of smoking cessation attempts.
Methods: Data were collected in Clermont-Ferrand from a smoking cessation clinic between 1999 and 2009 (1,361 patients). Smoking cessation was considered a success when patients were abstinent 6 months after the beginning of cessation.
Peripheral T-cell lymphoma (PTCL) is a group of diseases with poor outcome and few therapeutic options. We aimed to assess the efficacy of bendamustine in real life cohort of patients.Between November 2009 and March 2015, 138 PTCL patients were treated with bendamustine in 27 centers.
View Article and Find Full Text PDFHepatitis C virus (HCV) infection is frequent among HIV-infected patients. We describe, the characteristics of 6 HIV/HCV-coinfected patients with B-cell non-Hodgkin lymphoma (NHL) included in a prospective cohort study of HIV-related lymphomas. Five of the 6 cases had features of marginal zone/lymphoplasmacytic NHL versus 1 of 33 HIV only-infected patients.
View Article and Find Full Text PDFPurpose: To determine the efficacy and safety of bendamustine as a single agent in refractory or relapsed T-cell lymphomas.
Patients And Methods: Patients with histologically confirmed peripheral T-cell lymphoma (PTCL) or cutaneous T-cell lymphoma who progressed after one or more lines of prior chemotherapy received bendamustine at 120 mg/m(2) per day on days 1 through 2 every 3 weeks for six cycles. The primary end point was overall response rate (ORR).
Background: In angioimmunoblastic T-cell lymphoma, symptoms linked to B-lymphocyte activation are common, and variable numbers of CD20(+) large B-blasts, often infected by Epstein-Barr virus, are found in tumor tissues. We postulated that the disruption of putative B-T interactions and/or depletion of the Epstein-Barr virus reservoir by an anti-CD20 monoclonal antibody (rituximab) could improve the clinical outcome produced by conventional chemotherapy.
Design And Methods: Twenty-five newly diagnosed patients were treated, in a phase II study, with eight cycles of rituximab + chemotherapy (R-CHOP21).
Hydroxyurea is the standard therapy of chronic myelomonocytic leukemia (CMML) presenting with advanced myeloproliferative and/or myelodysplastic features. Response to hypomethylating agents has been reported in heterogeneous series of CMML. We conducted a phase 2 trial of decitabine (DAC) in 39 patients with advanced CMML defined according to a previous trial.
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