Publications by authors named "Pascale Flandrin Gresta"

Introduction: VEXAS syndrome (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic), recently described, due to a somatic mutation of the UBA1 gene and often associated with hemopathy, is characterized by systemic symptoms close to those described in Still's disease or relapsing polychondritis. There are also patients with hemopathy, presenting inflammatory symptoms reminiscent of those of VEXAS syndrome but without mutation of the UBA1 gene.

Case/discussion: Two male patients consulted for general signs, dermatological symptoms, arthralgia, chondritis and venous thrombosis, like patients in the French cohort suffering from VEXAS syndrome.

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  • Despite initial treatment with midostaurin (MIDO) and chemotherapy in FLT3-mutated acute myeloid leukemia (AML), many patients face relapses, with complete remission rates around 60-70% and over 40% relapsing.
  • A study of 150 patients with refractory/relapsed (R/R) AML revealed that those treated with MIDO showed lower persistence of FLT3-ITD mutations compared to those who did not receive MIDO (68% vs. 87.5%).
  • The study found that detecting multiple FLT3-ITD clones at diagnosis related to a higher persistence rate of these mutations at relapse, indicating the need for sensitive techniques in FLT3-
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Patients with Core-Binding Factor (CBF) and NPM1-mutated acute myeloid leukemia (AML) can be monitored by quantitative PCR after having achieved first complete remission (CR) to detect morphologic relapse and drive preemptive therapy. How to best manage these patients is unknown. We retrospectively analyzed 303 patients with CBF and NPM1-mutated AML, aged 18-60 years, without allogeneic hematopoietic cell transplantation (HCT) in first CR, with molecular monitoring after first-line intensive therapy.

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  • * The GBMHM has organized External Evaluation of Quality (EEQ) programs and training for 64 French labs, focusing on standardizing tests like V617F and lymphoid clonality.
  • * A study analyzed quality control results over 10 years, showing that these initiatives led to improved technical performance and reproducibility of test results across labs adhering to national guidelines.
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Acute myeloid leukemias (AMLs) are hematologic malignancies with varied molecular and immunophenotypic profiles, making them difficult to diagnose and classify. High-dimensional analysis algorithms might increase the utility of multicolor flow cytometry for AML diagnosis and follow-up. The objective of the present study was to assess whether a Compass database-guided analysis can be used to achieve rapid and accurate diagnoses.

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Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by the presence of transcript as a result of reciprocal translocation between chromosome 9 and 22. The most common transcripts subtypes are e13a2 (b2a2) and e14a2 (b3a2). The prognostic impact of the type of transcript has been the subject of controversies over time.

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Chronic myelomonocytic leukemia (CMML) is a myelodysplastic/myeloproliferative neoplasm, characterized by persistent monocytosis and dysplasia in at least one myeloid cell lineage. This persistent monocytosis should be distinguished from the reactive monocytosis which is sometimes observed in a context of infections or solid tumors. In 2015, Selimoglu-Buet et al.

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Embryonic stem cells typically show properties of long-term self-renewal and lack of differentiation. When appropriately stimulated, they are able to differentiate into all cell lineages, and lose their self-renewal characteristics. These properties are controlled by a series of genes encoding several transcription factors, including OCT4, the product of POU5F1 gene.

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  • Acute myeloid leukemia (AML) is fueled by leukemic stem cells, which show unique traits like self-renewal and expression of embryonic genes compared to normal blood stem cells.
  • The study focused on the expression of specific embryonic antigens (OCT4, NANOG, SOX2, SSEA1, SSEA3) in normal and AML hematopoietic stem cell subsets, revealing that OCT4 and SOX2 were elevated in leukemic cells, while SSEA1 was reduced.
  • Despite higher levels of SOX2 being linked to better survival rates among AML patients, the expression of these markers did not appear to affect treatment outcomes or remission
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  • * In a study with two cohorts, skipping of TET2 exon 2 (TET2E2S) was independent of age and cytogenetics and associated with a significantly lower risk of relapse and improved survival, especially in younger patients with cytogenetically normal AML.
  • * TET2E2S was the only prognostic factor for overall survival and positively influenced survival across various genetic risk categories, suggesting that monitoring TET2 exon 2 splicing could enhance patient risk assessments in AML treatments.
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Azacitidine inhibits DNA methyltransferases, including DNMT1, and is currently the standard of care for patients with higher-risk myelodysplastic syndrome (HRMDS) or low blast count acute myeloid leukemia (AML). The expression of 754 miRNAs was compared in azacitidine-resistant and azacitidine-sensitive myelodysplastic syndrome cells. We investigated the role of differentially expressed miRNAs on DNMT1 expression and azacitidine resistance We next evaluated anti-DNMT1 miRNA expression in pretreatment bone marrow samples derived from 75 patients treated with azacitidine for HRMDS or AML.

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Over recent years, the development of molecular biology techniques has improved the hematological diseases diagnostic and follow-up. Consequently, these techniques are largely used in the biological screening of these diseases; therefore the Hemato-oncology molecular diagnostics laboratories must be actively involved in the accreditation process according the ISO 15189 standard. The French group of molecular biologists (GBMHM) provides requirements for the implementation of quality assurance for the medical molecular laboratories.

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  • The study investigates how mutations in spliceosome genes, oncogene expression, and drug resistance in Acute Myeloid Leukemia (AML) affect exon expression.
  • Exon-array analysis and exon-specific PCR were used to analyze exon expression in AML cell lines and patient samples, finding over 70% validation of identified exon events.
  • Results highlighted significant differences in exon events between chemosensitive and chemoresistant AML, revealing new potential pathways for targeting drug resistance linked to DEK and WT1 oncogenes.
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CXCR4, receptor of the chemokine SDF-1 (stromal cell-derived factor 1) plays a major role in the normal hematopoiesis but also in the biology of the leukaemic cell. This receptor is expressed on the surface of blasts and is a key molecule in "the anchoring" of the leukaemic stem cell (LSC) within the bone marrow niche. The interactions of the LSC with the bone marrow microenvironment promote survival signals and drug resistance.

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Myelodysplastic syndromes are characterized by a high risk of evolution into acute myeloid leukaemia which can involve activation of signalling pathways. As the chaperone heat shock protein 90 (HSP90) has a key role in signal transduction, we investigated its role in the pathogenesis and evolution of myelodysplastic syndromes. Expressions of HSP90 and signalling proteins clients (phosphorylated-AKT (pAKT), Focal Adhesion Kinase (FAK) and phosphorylated-FAK (pFAK)), were assessed in bone marrow mononuclear and CD34-positive (CD34+) cells from 177 patients with myelodysplasia.

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Purpose: HSP90 targeting is a promising therapeutic approach in cancer. 17-AAG is an HSP90 inhibitor with completed Phase I trials in patients with advanced cancer and recently published Phase II trials. The aim of this work was to study the expression of HSP 90 and apoptotic proteins, the effects in culture of 17-AAG on cell survival and apoptosis and to compare Philadelphia-positive (Ph+) ALL to common B cell ALL, in ALL cell lines and in patients' cells collected at ALL diagnosis.

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Direct cell-cell contact between haematopoietic progenitor cells (HPCs) and their cellular microenvironment is essential to maintain 'stemness'. In cancer biology, focal adhesion (FA) proteins are involved in survival signal transduction in a wide variety of human tumours. To define the role of FA proteins in the haematopoietic microenvironment of myelodysplastic syndromes (MDS), CD73-positive mesenchymal stromal cells (MSCs) were immunostained for paxillin, pFAK [Y(397)], and HSP90α/β and p130CAS, and analysed for reactivity, intensity and cellular localisation.

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Background: Congenital acute leukemia is a rare event, presenting usually as an aggressive disease with a poor prognosis. A differential diagnosis is the transient myeloproliferative disorder observed in Down syndrome. We describe the case of an apparently healthy newborn male child presenting with normal peripheral blood (PB) counts but with a blast population on differentials.

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