Publications by authors named "Mael Heiblig"

Article Synopsis
  • MENin-KMT2A inhibitors (MENi) are new drugs being tested for treating specific types of acute myeloid leukemia (AML), particularly KMT2Ar and NPM1 cases.
  • A 71-year-old woman treated with the MENi revumenib (REV) for relapsed NPM1 AML developed a serious skin condition resembling pyoderma gangrenosum after two weeks.
  • This case is significant as it is the first documented instance of MENi causing this type of skin condition, emphasizing the need to monitor for severe skin-related side effects in patients undergoing treatment with MENi.
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Unlabelled: This phase 2 study investigated pevonedistat + azacitidine + venetoclax ( = 83) versus azacitidine + venetoclax ( = 81) in patients with newly diagnosed acute myeloid leukemia (AML) ineligible for intensive chemotherapy. The study was stopped early following negative results from PANTHER, which evaluated pevonedistat in higher-risk myelodysplastic syndromes/chronic myelomonocytic leukemia or low-blast AML. Outcomes were analyzed up to the datacut.

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  • * The study, called KOMET-001, was conducted in multiple countries and involved dose-escalation and validation phases, with patients in specific molecular subtypes receiving varying doses of ziftomenib over 28-day cycles.
  • * Results indicated that 83 patients were treated with ziftomenib from September 2019 to August 2022, and the findings are crucial for determining the drug's safety and effectiveness for future phases of clinical testing.
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  • Advanced systemic mastocytosis (AdvSM) is a complex condition linked to poor outcomes, and while midostaurin is the first approved treatment, its long-lasting effectiveness is limited.
  • Various prognostic scoring systems like MARS, IPSM, and GPSM have been developed to assess patients' outcomes, but it's essential to tailor these scores to specific AdvSM subtypes for better accuracy.
  • A study of patients treated with midostaurin revealed that MARS and AdvSM subtype significantly predict overall survival, identifying five distinct patient subgroups with varying median survival times, highlighting the need for personalized management strategies.
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  • VEXAS syndrome, identified in 2020, is caused by mutations in the UBA1 gene and shows a variety of clinical and hematological features, making it challenging to distinguish from other inflammatory conditions. !* -
  • This study collected a dataset of 9,514 images of polymorphonuclear cells (PMNs) and used a convolutional neural network (CNN) to automate the detection of specific dysplastic features unique to VEXAS, achieving a high level of accuracy (AUC of 0.85-0.97). !* -
  • Results indicate that automated analysis can effectively support hematologists in identifying potential VEXAS cases, suggesting a screening score for UBA1 mutational
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Objectives: 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.

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Background And Aims: Systemic mastocytosis (SM) is characterized by the accumulation of atypical mast cells (MCs) in organs. Liver histology of SM has been marginally described and accurate histological classification is critical, given the consequences of aggressive SM diagnosis. We aimed to describe the histological features associated with liver SM using updated tools.

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  • 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.
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The recently discovered VEXAS syndrome is caused by the clonal expansion of hematopoietic stem or progenitor cells with acquired mutations in UBA1 gene, which encodes for a key enzyme of the ubiquitylation proteasome system. As a result, a shorter cytoplasmic isoform of UBA1 is transcribed, which is non-functional. The disease is characterized by non-specific and highly heterogeneous inflammatory manifestations and macrocytic anemia.

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Background: Mastocytosis and monoclonal mast cell (MC) activation syndrome (MMAS) are heterogeneous conditions characterized by the accumulation of atypical MCs. Despite the recurrent involvement of KIT mutations, the pathophysiologic origin of mastocytosis and MMAS is unclear. Although hereditary α-tryptasemia (HαT, related to TPSAB1 gene duplication) is abnormally frequent in these diseases, it is not known whether the association is coincidental or causal.

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Tamibarotene-based therapy is a novel targeted approach for the treatment of relapsed/refractory (R/R) acute myeloid leukemia (AML) with retinoic acid receptor alpha () gene overexpression. Approximately, 50% of higher-risk myelodysplastic syndrome (MDS) patients and approximately 30% of AML patients are positive for overexpression using a blood-based biomarker test that measures expression in peripheral blasts. A phase 2 study investigating the activity of tamibarotene in patients with overexpression was conducted in patients with AML and MDS (NCT02807558).

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Background: t-AML occurs after a primary malignancy treatment and retains a poor prognosis.

Aims: To determine the impact of primary malignancies, therapeutic strategies, and prognostic factors on clinical outcomes of t-AML.

Results: A total of 112 adult patients were included in this study.

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Population-based studies and case reports suggest that there may be an increased risk of acute leukemia associated with sickle cell disease (SCD). Following the description of a new case report, an extensive review of the literature identified 51 previously described cases. Most cases study showed myelodysplastic features confirmed, when available, by genetic markers such as chromosome 5 and/or chromosome 7 abnormalities and TP53 gene mutations.

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Whether the LSC17 gene expression can improve risk stratification in the context of next generation sequencing-based risk stratification and measurable residual disease (MRD) in patients with intensively treated AML has not been explored. We analyzed LSC17 in 504 adult patients prospectively treated in the ALFA-0702 trial. RUNX1 or TP53 mutations were associated with higher LSC1 scores while CEBPA and NPM1 mutations were associated with lower scores.

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Article Synopsis
  • VEXAS syndrome is a newly described condition that raises questions about the classification of myelodysplastic syndromes in medical diagnosis.
  • This syndrome involves clonal expansion from somatic mutations and is linked to features like dysplastic blood cells and low blood cell counts, complicating the lines between healthy and unhealthy hematopoiesis.
  • The authors propose a refined classification system for hematopoiesis, suggesting that VEXAS may not fit the traditional criteria for myelodysplastic syndromes, and introducing terms to better differentiate types of clonal hematopoiesis.
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Background: Poly(ADP-ribose) polymerase inhibitors (PARPi) are increasingly used in oncology; their hematological toxicities affect classically red, platelet and neutrophil lineages, but some opportunistic infections have been reported concomitantly to deep lymphopenias.

Objective: This study was designed to provide an external and internal analysis of the crossed impacts of PARPi and age on lymphopenia risk.

Patients And Methods: A scoping review was performed on the PubMed and Embase databases to assess the reporting of lymphocyte rates in original studies on PARPi treatment for adult patients up to 1 April 2022.

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  • The study explores the role of the transcription factor CCAAT-enhancer binding protein α (C/EBPα) in lipid metabolism and cellular homeostasis in acute myeloid leukemia (AML), particularly with mutations in FLT3.
  • Researchers found that C/EBPα and FLT3 activation enhance lipid production and desaturation in AML cells, leading to increased vulnerability to oxidative stress.
  • Inhibiting C/EBPα or FLT3 demonstrates potential for therapeutic strategies targeting lipid metabolism to promote ferroptotic cell death in FLT3-mutant AML, a type of leukemia affecting 30% of patients.
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