Publications by authors named "Clara Mariette"

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.
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Therapeutic strategies for patients with newly diagnosed multiple myeloma (NDMM) have considerably improved during the last 10 years. The IFM2014-03 trial proposed an all-oral triplet induction/consolidation regimen in transplant-eligible NDMM patients, followed by lenalidomide maintenance. Induction consisted of three 21-day cycles of ixazomib, lenalidomide and dexamethasone (IRd), before high-dose Melphalan with transplant followed by eight 28-day cycles of IRd consolidation before 13 cycles of lenalidomide maintenance.

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  • * In a study of 50 patients with severe renal impairment, only one death occurred within the first 100 days post-transplant, with most patients showing significant improvements in hematological responses.
  • * Overall, after two years, 84% of patients were alive, 70% were free from disease progression, and 59% saw an improvement in kidney function, indicating that the procedure is both safe and effective for this population.
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Introduction: Despite the implementation of new therapeutic agents, management of relapsed multiple myeloma (MM) remains a challenge. Salvage autologous hematopoietic cell transplant (AHCT) remains a valid therapeutic option for eligible patients who achieve prolonged response after a first AHCT. However, a second graft is not always available, and these patients may need a second mobilization.

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  • Familial forms of monoclonal gammopathy, including multiple myeloma (MM) and Monoclonal Gammopathy of Undetermined Significance (MGUS), are rare, with MGUS being more commonly observed and sometimes advancing to MM.
  • A study identified 318 families with multiple cases of monoclonal gammopathy, highlighting potential genetic links and family clusters with parent-child and sibling cases.
  • Despite some genetic similarities, familial cases generally present similarly to sporadic cases but show a better prognosis, with longer median survival rates for those with familial MM.
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  • High-dose melphalan (HDM) combined with bortezomib (Bor-HDM) was tested in a phase 3 trial for patients with multiple myeloma to see if it was more effective than HDM alone.* -
  • The trial included 300 patients, and results showed no significant differences in complete response rates or minimum residual disease rates between the two treatment groups.* -
  • Although progression-free survival was slightly better in the Bor-HDM group (34.0 months) compared to HDM (29.6 months), the overall survival rates and serious adverse events were similar, indicating Bor-HDM did not provide a clear advantage.*
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Multiple myeloma (MM) is rare in young patients, especially before age 40 years at diagnosis, representing <2% of all patients with MM. Little is known about the disease characteristics and prognosis of these patients. In this study, we examined 214 patients diagnosed with MM at age ≤40 years over 15 years, in the era of modern treatments.

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Bortezomib, lenalidomide, and dexamethasone plus transplant is a standard of care for eligible patients with multiple myeloma. Because responses can deepen with time, regimens with longer and more potent induction/consolidation phases are needed. In this phase 2 study, patients received eight 28-day cycles of carfilzomib (K) 20/36 mg/m2 (days 1-2, 8-9, 15-16), lenalidomide (R) 25 mg (days 1-21), and dexamethasone (d) 20 mg (days 1-2, 8-9, 15-16, 22-23).

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Suspicion of myelodysplastic syndromes (MDS) is the most common reason for bone marrow aspirate in elderly patients. This study aimed to prospectively validate the accuracy for flow cytometric analysis of peripheral blood neutrophil myeloperoxidase expression in ruling out MDS. We enrolled 62 consecutive patients who were referred for suspected MDS, based on medical history and peripheral blood cytopenia.

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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
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  • Erythropoiesis-stimulating agents are the first-line treatment for anemia in patients with lower-risk myelodysplastic syndrome, with a study analyzing their effectiveness and associated biomarkers.
  • The study included 70 elderly patients with various forms of myelodysplastic syndrome, assessing multiple factors like serum erythropoietin levels and the RED score to predict treatment response.
  • Results showed nearly half (48%) of the patients had an erythroid response, with predictors of low response being higher RED scores and lower hepcidin:ferritin ratios.
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We investigated extramedullary disease in newly diagnosed multiple myeloma patients and its impact on outcome following first-line autologous stem cell transplantation. We identified 3744 adult myeloma patients who received up-front single (n=3391) or tandem transplantation (n=353) between 2005 and 2014 with available data on extramedullary involvement at diagnosis. The overall incidence of extramedullary disease was 18.

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Little data have been published concerning invasive fungal infections during treatment of acute lymphoblastic leukemia (ALL). Patients included between May 2006 and October 2012 in the multicenter phase III trial for newly diagnosed ALL (GRAALL-2005) were retrospectively reviewed for the occurrence of IFI using the EORTC modified criteria. These patients did not routinely receive antifungal prophylaxis.

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  • Short intensive chemotherapy is the standard treatment for adult patients with Burkitt's lymphoma/leukaemia, with studies indicating that adding rituximab may enhance outcomes.
  • A randomized, phase 3 trial was conducted in France involving HIV-negative adults with untreated Burkitt's lymphoma, using stratification based on disease spread and age.
  • The study's primary goal was to evaluate the 3-year event-free survival rate among patients receiving rituximab with chemotherapy versus those receiving chemotherapy alone.
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A large, multicentre, retrospective survey of patients with hairy cell leukaemia (HCL) was conducted in France to determine the frequency of second malignancies and to analyse the long-term effects of the established purine nucleoside analogues (PNAs), cladribine and pentostatin. The survey retrospectively reviewed the medical history of patients and their immediate family, clinical and biological presentation at the time of HCL diagnosis, treatment choice, response to treatment, time to relapse and cause of death. Data were collected for 487 patients with HCL.

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