Publications by authors named "Pigneux A"

Acute myeloid leukaemia (AML) arising from a myeloproliferative neoplasm (MPN) is more aggressive and less responsive to therapies compared to de novo AML. Olutasidenib, an oral small-molecule inhibitor of mutated IDH1 (mIDH1), showed encouraging and durable responses in a phase 1/2 study of adults with post-MPN mIDH1 AML. Patients received olutasidenib 150 mg BID monotherapy or in combination with azacitidine.

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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.

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CPX-351 has been approved for patients with therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (MRC-AML). No extensive data are available on MRD and long-term clinical outcome using CPX-351 in AML in real-life. We retrospectively collected data from 168 patients in 36 centers in France and Italy who had received one or two cycles of induction with CPX-351.

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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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  • A new community of heads of haematology departments has been formed to provide mutual support in response to challenges within the French hospital system.
  • An inaugural seminar held in January 2023 laid the groundwork for this initiative, fostering connections and collaboration among participants.
  • The community expanded in January 2024, involving a wider group of department heads, enhancing teamwork and resource-sharing to improve hospital management and operations.
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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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Background: ABBV-184, a novel survivin peptide-targeting T-cell receptor (TCR)/anti-CD3 bispecific protein, demonstrated preclinical T-cell activation and cytotoxicity toward HLA-A2:01-positive tumor lines. This first-in-human trial evaluated ABBV-184 monotherapy in patients with acute myeloid leukemia (AML) and non-small cell lung cancer (NSCLC).

Research Design And Methods: This phase 1 multicenter, open-label, dose escalation trial (NCT04272203) enrolled adult patients with relapsed/refractory AML or NSCLC with an HLA-A2:01 restricted genotype.

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  • Venetoclax-azacitidine is the standard treatment for unfit acute myeloid leukemia patients, but there is limited data on how long patients should continue therapy if they cannot tolerate it.
  • In a study analyzing patients who stopped treatment due to poor tolerance, those who discontinued showed comparable outcomes to those who continued with azacitidine alone, with median overall survival of 44 months for newly diagnosed patients.
  • The findings suggest that patients who stop treatment while in remission can have favorable outcomes, indicating a need for further controlled trials to explore optimal treatment durations.
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  • 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.
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  • In patients with acute myeloid leukemia (AML), a higher presence of Vγ9Vδ2 T cells at diagnosis is associated with better overall and relapse-free survival rates.
  • This study analyzed immunophenotypic data from 198 newly diagnosed AML patients to determine how Vγ9Vδ2 T-cell frequency impacts prognosis while adjusting for various confounding factors.
  • The findings support the importance of Vγ9Vδ2 T cells in AML prognosis and suggest potential treatment strategies that could boost these T-cell responses in patients.
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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).

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  • 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.
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  • Therapies for relapsed/refractory acute myeloid leukemia (AML) are limited, particularly for patients who can't tolerate standard treatments, prompting the evaluation of a new combination therapy.
  • In a phase 1b trial, 30 patients were treated with venetoclax, a BCL-2 inhibitor, and cobimetinib, a MEK1/2 inhibitor, but experienced significant adverse effects like diarrhea, nausea, and fatigue, leading to dose modifications in many cases.
  • The combination therapy showed a low overall response rate (15.6% complete remission) and suggested that certain baseline biological markers may help predict patient responses, indicating limited efficacy similar to single-agent venetoclax but with increased toxicity.
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Very few data are available about hypomethylating agent (HMA) efficiency in core binding factor acute myeloid leukemias (CBF-AML). Our main objective was to evaluate the efficacy and safety of HMA in the specific subset of CBF-AML. Here, we report the results of a multicenter retrospective French study about efficacy of HMA monotherapy, used frontline or for R/R CBF-AML.

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  • Researchers created AI-based prediction models using data from 3,687 acute myeloid leukemia patients, focusing on two treatment types: intensive chemotherapy and azacitidine.
  • A multilayer perceptron neural network demonstrated prediction accuracies of 68.5% for intensive chemotherapy patients and 62.1% for those treated with azacitidine.
  • The Boruta algorithm effectively identified key diagnostic features needed for predictions, streamlining the complexity of data analysis for hematologists and potentially improving treatment decisions.
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  • EBV-positive post-transplant lymphoproliferative disease (PTLD) is a rare and aggressive condition that can occur in patients after hematopoietic cell transplant due to their weakened immune systems.
  • Nearly half of the patients with EBV PTLD do not respond to the initial rituximab treatment, leading to limited options and a lack of established care strategies for those who relapse or are refractory.
  • A study of 81 patients revealed that the average survival time after treatment failure is only 0.7 months, with PTLD, graft-versus-host disease, and treatment-related issues being the primary causes of death, indicating a critical need for better treatment solutions.
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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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Tandem duplications (TDs) of the UBTF gene have been recently described as a recurrent alteration in pediatric acute myeloid leukemia (AML). Here, by screening 1946 newly diagnosed adult AML, we found that UBTF-TDs occur in about 3% of patients aged 18-60 years, in a mutually exclusive pattern with other known AML subtype-defining alterations. The characteristics of 59 adults with UBTF-TD AML included young age (median 37 years), low bone marrow (BM) blast infiltration (median 25%), and high rates of WT1 mutations (61%), FLT3-ITDs (51%) and trisomy 8 (29%).

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Patient-reported outcomes (PROs) can inform treatment selection and assess treatment value in acute myeloid leukemia (AML). We evaluated PROs from the ADMIRAL trial (NCT02421939) in patients with -mutated relapsed/refractory (R/R) AML. PRO instruments consisted of Brief Fatigue Inventory (BFI), Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu), Functional Assessment of Chronic Illness Therapy-Dyspnea Short Form (FACIT-Dys SF), EuroQoL 5-Dimension 5-Level (EQ-5D-5L), and leukemia treatment-specific symptom questionnaires.

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Elderly patients with acute myeloid leukemia, ineligible for intensive chemotherapy, have long had a very poor prognosis and have always represented one of the main patient populations included in early phase clinical research trials. In recent years, many molecules have shown very interesting efficacy, often targeted therapies whose indication is based on a specific mutation profile (gilteritinib, ivosidenib), or mutation-independent (venetoclax), but also drugs whose indication is based on a specific biomarker (tamibarotene) or on new generation immunotherapies targeting macrophages (magrolimab) or other immune effectors while targeting leukemic cells resulting in forced immunological synapse (flotetuzumab) or activation of lymphocyte effectors associated with inhibition of the AML cells' stem signature in their microenvironment (cusatuzumab sabatolimab). All of these new strategies are discussed in this review, as well as the challenges of this frail population, which has benefited in recent months from all the major advances in the field, questioning in a second phase the modification of practices in younger patients.

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Olutasidenib (FT-2102) is a potent, selective, oral, small-molecule inhibitor of mutant isocitrate dehydrogenase 1 (mIDH1). Overall, 153 IDH1 inhibitor-naive patients with mIDH1R132 relapsed/refractory (R/R) acute myeloid leukemia (AML) received olutasidenib monotherapy 150 mg twice daily in the pivotal cohort of this study. The median age of participants was 71 years (range, 32-87 years) and the median number of prior regimens received by patients was 2 (1-7).

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NPM 1-mutated acute myeloid leukemia (AML) shows unique features. However, the characteristics of "therapy-related" NPM1-mutated AML (t-NPM1 AML) are poorly understood. We compared the genetics, transcriptional profile, and clinical outcomes of t-NPM1 AML, de novo NPM1-mutated AML (dn-NPM1 AML), and therapy-related AML (t-AML) with wild-type NPM1 (t-AML).

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Background: Recently, the combination of venetoclax plus a hypomethylating agent (HMA; azacitidine ordecitabine) or low-dose cytarabine (LDAC) showed promise in Phase III trials in previously untreated AML. In France at the time of this study, venetoclax was not yet approved for AML and there were therefore no formal usage recommendations. Here we report the first study in a French cohort that assessed venetoclax in combination with existing treatments for AML under real-life conditions.

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