Publications by authors named "Leguay T"

According to current recommendations, older AML patients in first complete remission (CR) after induction chemotherapy should receive consolidation with intermediate-dose cytarabine (IDAC). However, no study has demonstrated the superiority of IDAC over other regimen. In this retrospective study, we compared the efficacy of mini-consolidations (idarubicin 8 mg/m day 1, cytarabine 50 mg/m/12 h, day 1-5) and IDAC.

View Article and Find Full Text PDF

Purpose: The use of inotuzumab ozogamicin (InO), a conjugated anti-CD22 monoclonal antibody, is becoming a promising frontline treatment for older patients with ALL.

Patients And Methods: EWALL-INO is an open-label prospective multicenter phase II trial (ClinicalTrials.gov identifier: NCT03249870).

View Article and Find Full Text PDF

Purpose: quantification is widely regarded as the standard for monitoring measurable residual disease (MRD) in Philadelphia chromosome-positive (Ph+) ALL. However, recent evidence of multilineage involvement questions the significance of MRD. We aimed to define the prognostic role of MRD as assessed by or lymphoid-specific immunoglobulin/T-cell receptor () gene markers.

View Article and Find Full Text PDF
Article Synopsis
  • Acute myeloid leukemia (AML) with BCR::ABL1 is classified as an adverse-risk group in the 2022 ELN classification, but its outcomes with modern treatment options like tyrosine kinase inhibitors are not well understood.
  • In a study of 20 patients with de novo BCR::ABL1 AML from a large registry, most received standard chemotherapy with imatinib, leading to a high complete remission rate of 94.4%.
  • The survival rates suggest BCR::ABL1 AML patients have better outcomes than those classified in traditional adverse-risk categories, indicating they may need reclassification in future treatment guidelines.
View Article and Find Full Text PDF

Risk stratification and treatment response evaluation are key features in acute myeloid leukemia (AML) management. Immunophenotypic and molecular approaches all rely on the detection of persisting leukemic cells by measurable residual disease techniques. A new approach is proposed here by assessing medullary myeloid maturation by flow cytometry through a myeloid progenitor ratio (MPR).

View Article and Find Full Text PDF
Article Synopsis
  • Acute myeloid leukemia (AML) with myelodysplasia-related characteristics presents a mixed prognosis, and there's limited understanding of patient outcomes after first-line treatment in refractory or relapsed cases.
  • A study involving 183 patients found that the median overall survival was 4.2 months, with no significant survival difference between refractory and relapsed patients; however, patients receiving best supportive care had markedly poorer outcomes.
  • The research suggests that both intensive chemotherapy and azacitidine are viable treatment options for this tough-to-treat population, and emphasizes the need for further exploration of new targeted therapies.
View Article and Find Full Text PDF

Background: Brexucabtagene autoleucel (brexu-cel) is an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy approved in the USA for adults with relapsed or refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL) and in the European Union for patients ≥26 years with R/R B-ALL. After 2 years of follow-up in ZUMA-3, the overall complete remission (CR) rate (CR+CR with incomplete hematological recovery (CRi)) was 73%, and the median overall survival (OS) was 25.4 months in 78 Phase 1 and 2 patients with R/R B-ALL who received the pivotal dose of brexu-cel.

View Article and Find Full Text PDF
Article Synopsis
  • * In a study of 1091 adult patients, 12.9% had KMT2A-r, with a 5-year relapse rate of 40.7% and overall survival rate of 53.3%. The presence of specific gene alterations like TP53 and IKZF1 correlated with significantly worse outcomes.
  • * The analysis showed that measuring minimal residual disease (MRD) using KMT2A markers was more reliable than other methods, indicating that patients responding well early
View Article and Find Full Text PDF

Whereas the prognosis of adult patients with Philadelphia-negative acute lymphoblastic leukemia (ALL) has greatly improved since the advent of pediatric-inspired regimens, the impact of initial central nervous system (CNS) involvement has not been formerly re-evaluated. We report here the outcome of patients with initial CNS involvement included in the pediatric-inspired prospective randomized GRAALL-2005 study. Between 2006 and 2014, 784 adult patients (aged 18-59 years) with newly diagnosed Philadelphia-negative ALL were included, of whom 55 (7%) had CNS involvement.

View Article and Find Full Text PDF

Unlabelled: Low hypodiploidy defines a rare subtype of B-cell acute lymphoblastic leukemia (B-ALL) with a dismal outcome. To investigate the genomic basis of low-hypodiploid ALL (LH-ALL) in adults, we analyzed copy-number aberrations, loss of heterozygosity, mutations, and cytogenetics data in a prospective cohort of Philadelphia (Ph)-negative B-ALL patients (n = 591, ages 18-84 years), allowing us to identify 80 LH-ALL cases (14%). Genomic analysis was critical for evidencing low hypodiploidy in many cases missed by cytogenetics.

View Article and Find Full Text PDF

Background: Brexucabtagene autoleucel (KTE-X19) is an autologous anti-CD19 CAR T-cell therapy approved in the USA to treat adult patients with relapsed or refractory B-precursor acute lymphoblastic leukemia (R/R B-ALL) based on ZUMA-3 study results. We report updated ZUMA-3 outcomes with longer follow-up and an extended data set along with contextualization of outcomes to historical standard of care.

Methods: Adults with R/R B-ALL received a single infusion of KTE-X19 (1 × 10 CAR T cells/kg).

View Article and Find Full Text PDF
Article Synopsis
  • The study involved 526 acute myeloid leukemia patients who were not responding to or were relapsing after chemotherapy, with treatment options including intensive salvage chemotherapy, azacitidine, and best supportive care.
  • Complete response rates varied significantly among the treatment groups, with intensive chemotherapy showing the best outcomes, while azacitidine had limited effectiveness.
  • Predictive factors for worse survival included certain leukemia history, high bone marrow blasts, and adverse genetics, with AZA being beneficial in the short term but lacking in long-term survival for older patients.
View Article and Find Full Text PDF

Adults with relapsed or refractory B-precursor acute lymphoblastic leukaemia (R/R BCP-ALL) have very poor outcome. Blinatumomab as single agent has shown activity in R/R BCP-ALL. We aimed to assess the activity of blinatumomab in concomitant association with intensive chemotherapy.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates B-cell acute lymphoblastic leukemia (B-ALL) in adults to identify new genetic drivers behind the disease through RNA sequencing and whole-genome analyses, revealing a novel subtype with a distinct gene expression.
  • This new subtype features unique genomic microdeletions, leading to a fusion of UBTF and ATXN7L3 genes, as well as deregulation of the CDX2 gene due to enhancer hijacking mechanisms.
  • Patients with this subtype (CDX2/UBTF ALL) are typically younger, predominantly female, exhibit poor treatment responses, and have a higher risk of disease relapse compared to other B-ALL patients.
View Article and Find Full Text PDF
Article Synopsis
  • Blinatumomab is a bispecific T-cell engager used for treating B-cell precursor acute lymphoblastic leukemia (B-ALL) in patients who have minimal residual disease (MRD) or are in relapse, with a study analyzing 73 patients receiving this treatment.
  • The results showed that high pre-treatment MRD levels correlated with poorer outcomes, specifically shorter relapse-free survival and overall survival rates.
  • The study suggests that understanding tumor burden prior to treatment could lead to more personalized strategies for managing relapsed patients, highlighting the importance of MRD levels in treatment planning.
View Article and Find Full Text PDF

CAR-T Cells have opened new doors for cellular immunotherapies and provides new therapeutic options for patients with refractory B-cell malignancies, B-cell acute lymphoblastic leukemia and diffuse large B-cel lymphoma. CAR-T Cells have benefited from an accelerated approval procedure in many countries. Indeed, The French health authorities have approved the specialties Tisacel ® and Axicel ®, but additional data including the use of CAR-T Cells in real life were also mandatory.

View Article and Find Full Text PDF
Article Synopsis
  • The study examines the real-world use of antifungal prophylaxis (AFP) in patients with acute myeloblastic leukaemia (AML) after they receive induction chemotherapy, highlighting variations across different treatment centers.
  • Out of 677 patients, four AFP strategies were identified, with the group receiving no prophylaxis having the highest incidence of invasive fungal infections (IFI) and a significantly earlier onset compared to those on posaconazole.
  • AFP was found to delay the onset of IFIs and reduce their overall occurrence; however, misidentification of IFIs by investigators affects treatment management, impacting overall patient outcomes and rate of complete remission in AML.
View Article and Find Full Text PDF

Purpose: AXL has been shown to play a pivotal role in the selective response of -ITD acute myeloid leukemia (AML) cells to FLT3 tyrosine kinase inhibitors (TKI), particularly within the bone marrow microenvironment.

Experimental Design: Herein, we compared the effect of dual FLT3/AXL-TKI gilteritinib with quizartinib through models mimicking hematopoietic niche conditions, in primary AML blasts, and with dosing regimens allowing plasma concentration close to those used in clinical trials.

Results: We observed that gilteritinib maintained a stronger proapoptotic effect in hypoxia and coculture with bone marrow stromal cells compared with quizartinib, linked to a dose-dependent inhibition of AXL phosphorylation.

View Article and Find Full Text PDF

Background: Despite treatment with novel therapies and allogeneic stem-cell transplant (allo-SCT) consolidation, outcomes in adult patients with relapsed or refractory B-precursor acute lymphoblastic leukaemia remain poor, underlining the need for more effective therapies.

Methods: We report the pivotal phase 2 results of ZUMA-3, an international, multicentre, single-arm, open-label study evaluating the efficacy and safety of the autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy KTE-X19 in adult patients with relapsed or refractory B-precursor acute lymphoblastic leukaemia. Patients were enrolled at 25 sites in the USA, Canada, and Europe.

View Article and Find Full Text PDF

The assessment of minimal residual disease (MRD) is increasingly considered to monitor response to therapy in hematological malignancies. In acute myeloblastic leukemia (AML), molecular MRD (mMRD) is possible for about half the patients while multiparameter flow cytometry (MFC) is more broadly available. However, MFC analysis strategies are highly operator-dependent.

View Article and Find Full Text PDF