Publications by authors named "Comont T"
Article Synopsis
- Immunological checkpoint inhibitors, used in treating various cancers, can cause toxic side effects, particularly dermatological disorders.
- Common skin issues like maculopapular erythema and pruritus often occur, but rarer conditions such as fasciitis and scleroderma can also arise.
- Recognizing these unusual manifestations is crucial for internists, as they may mimic other diseases or paraneoplastic syndromes, requiring specific diagnostic and treatment approaches related to ICI toxicity.
In an open prospective, multicenter study enrolling 48 selected patients with chronic immune thrombocytopenia who achieved complete response for 1 year on thrombopoietin receptor agonists, half of the patients maintained a sustained response off treatment 4 years after treatment discontinuation.
View Article and Find Full Text PDFObjectives: Vacuoles, E1 enzyme, X-linked, autoinflammatory and somatic (VEXAS) syndrome is an adult-onset autoinflammatory disease associated with somatic ubiquitin-like modifier-activating enzyme 1 (UBA1) mutations. We aimed to evaluate the efficacy and safety of targeted therapies.
Methods: Multicentre retrospective study including patients with genetically proven VEXAS syndrome who had received at least one targeted therapy.
Myelodysplastic neoplasms (MDS) are characterized by clonal evolution starting from the compartment of hematopoietic stem and progenitors cells (HSPCs), leading in some cases to leukemic transformation. We hypothesized that deciphering the diversity of the HSPCs compartment may allow for the early detection of an emergent sub-clone that drives disease progression. Deep analysis of HSPCs repartition by multiparametric flow cytometry revealed a strong disorder of the hematopoietic branching system in most patients at diagnosis with different phenotypic signatures closely related to specific MDS features.
View Article and Find Full Text PDFArticle Synopsis
- - Immune checkpoint inhibitors (ICIs) like nivolumab can lead to rare immune-related adverse events, including acquired amegakaryocytic thrombocytopenia (AAT), which is characterized by low platelet counts and absence of megakaryocytes in the bone marrow.
- - A case study of a patient with metastatic melanoma showed that after 12 cycles of nivolumab, he developed AAT, but responded positively to eltrombopag, an oral drug known to increase platelet production.
- - Despite similar cases reported in literature, there’s uncertainty in treatment guidelines for immune-related AAT; ongoing research is needed to establish safety measures for therapies such as thrombopoietin receptor agonists in cancer patients.
The aim of this study was to assess the prevalence and the burden of difficult-to-treat primary ITP (pITP), defined by the need for another ITP treatment after romiplostim and eltrombopag. Adult patients were selected in the prospective, real-world CARMEN-France registry up to December 2021. Out of 821 adult patients with pITP, 29 had difficult-to-treat ITP (3.
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- Chronic myelomonocytic leukemia (CMML) is a complex blood disorder linked to kidney issues, prompting this study to examine kidney involvement in CMML patients, their treatments, and outcomes.
- In a multicenter retrospective study involving 16 CMML patients with kidney disease, common issues included kidney injury occurring roughly six months post-CMML diagnosis, with significant findings like lysozyme nephropathy and renal infiltration.
- Despite receiving treatment, many patients faced serious kidney complications, and although kidney involvement correlated with higher monocyte counts and treatment eligibility, there was no significant difference in survival rates compared to CMML controls.
Article Synopsis
- VEXAS syndrome is a poorly understood, acquired autoinflammatory disease linked to serious infections, highlighting significant risks for susceptible patients.
- A study of 74 patients revealed that the most frequent infection sites were the lungs, skin, and urinary tract, with a notable microbiological confirmation rate.
- Key risk factors for serious infections included age over 75, specific genetic mutations, and treatment with JAK inhibitors, with 36% of patients dying during the study, often due to these severe infections.
Article Synopsis
- Immune checkpoint inhibitors (ICIs) can cause liver toxicity in up to 25% of patients, and this study aimed to explore patterns of ICI-induced hepatitis and their outcomes.
- The study included 117 patients, finding that 38.5% had hepatocellular, 36.8% had cholestatic, and 24.8% had mixed liver injury, with severe cases linked to hepatocellular patterns.
- Treatment varied based on the clinical pattern, with steroids used for hepatocellular cases and ursodeoxycholic acid for cholestatic ones, and about 43.6% of patients challenged again with ICIs experienced recurrence of liver injury.
Sustained response off treatment (SROT) after thrombopoietin receptor agonist (TPO-RA) discontinuation has been reported in immune thrombocytopenia (ITP). This prospective multicenter interventional study enrolled adults with persistent or chronic primary ITP and complete response (CR) on TPO-RAs. The primary end point was the proportion of patients achieving SROT (platelet count >30 × 109/L and no bleeding) at week 24 (W24) with no other ITP-specific medications.
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- - Sickle cell disease (SCD) is a common genetic disorder caused by a mutation in the beta-globin chain, leading to distorted red blood cells and various severe health complications, including pain crises and infections.
- - Corticosteroids, although widely used for their anti-inflammatory properties and low cost, have well-documented adverse effects that may be particularly harmful to SCD patients, including inducing pain crises and increased hospitalizations.
- - Recent research suggests that high doses of corticosteroids do not provide benefits for acute SCD events, prompting the need for alternative preventive treatments like hydroxyurea or blood transfusions when corticosteroids are necessary.
Article Synopsis
- A study was conducted with 180 pregnant women and 168 nonpregnant women with immune thrombocytopenia (ITP) to assess the risks of ITP worsening during pregnancy and neonatal ITP (NITP).
- The findings showed that while pregnant women with ITP had a higher likelihood of severe thrombocytopenia recurrence and treatment changes, the overall risk of severe bleeding did not differ from nonpregnant women.
- NITP was identified in 14% of neonates, particularly linked to a mother's past history of NITP and low platelet counts close to delivery, providing valuable insights for advising women with ITP.
Impaired platelet production is a mechanism of immune thrombocytopenia (ITP). Morphological abnormalities of megakaryocytes (MKs) are sometimes observed in this disease. Two studies have suggested an association between MK abnormalities and response to corticosteroids in primary ITP, but none have investigated this association for thrombopoietin-receptor agonists (TPO-RAs).
View Article and Find Full Text PDFFrom Immune Dysregulations to Therapeutic Perspectives in Myelodysplastic Syndromes: A Review.
Diagnostics (Basel)
October 2021
The pathophysiology of myelodysplastic syndromes (MDSs) is complex and often includes immune dysregulation of both the innate and adaptive immune systems. Whereas clonal selection mainly involves smoldering inflammation, a cellular immunity dysfunction leads to increased apoptosis and blast proliferation. Addressing immune dysregulations in MDS is a recent concept that has allowed the identification of new therapeutic targets.
View Article and Find Full Text PDFData about the presentation and the management of primary immune thrombocytopenia (ITP) in very elderly patients (VEPs; aged ≥80 years) are lacking. The aim of the present study was to describe ITP in this subgroup. The data source was the prospective CARMEN-France registry.
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