Showing papers by "Anderson Loundou published in 2011"

Lymphocyte subset reconstitution after unrelated cord blood or bone marrow transplantation in children

Abstract: We report the post-transplant lymphocyte subset recovery of 226 children treated with Unrelated Cord Blood transplant (UCBT) (n = 112) or Unrelated Bone Marrow Transplant (UBMT) (n = 114) for malignant or non-malignant diseases. Absolute numbers of natural killer (NK), B and T cells were monitored by flow cytometry up to 5 years post-transplant. Immunological endpoints were: time to achieve a CD 3+ cell count >0·5 and 1·5 × 10 9 /1, CD4 + > 0·2 and 0·5 × 10 9 /1, CD8 + > 0·25 × 10 9 /1, CD19 + > 0·2 × 10 9 /1, NK > 0·1 × 10 9 /1. These endpoints were analysed through the use of cumulative incidence curves in the context of competing risks. CD8 + T cell recovery was delayed after UCBT with a median time to reach CD8 + T cells > 0·25 x 10 9 /1 of 7·7 months whereas it was 2·8 months in UBMT (P 0·2 × 10 9 /1 of 3·2 months in UCBT and 6·4 months in UBMT (P = 0·03). Median time for CD4 + T cell and NK cell recovery was similar in UCBT and UBMT. CD4 + T cells recovery was negatively correlated to age (better reconstitution in younger patients, P = 0·002). CD8 + T cells recovery was shorter in recipients with a positive cytomegalovirus serology (P = 0·001 ).

Variants in genetic modifiers of β-thalassemia can help to predict the major or intermedia type of the disease

Abstract: A cohort of 106 patients included in the French National Registry for Thalassemia were genotyped for 5 genetic modifiers of severity: i) β-thalassemia mutations; (ii) the XmnI SNP; (iii) the -3.7 kb α-thal deletion; (iv) the tag-SNP rs 11886868 in BCL11A exon 2; and (v) the tag-SNP rs9399137 in the HBSB1L-cMYB inter-region. Multivariate analysis was performed to study the risk of thalassemia Intermedia phenotype associated with the different combinations of alleles. The presence or absence of the favorable alleles could accurately predict the type of thalassemia in 83.2% of the cases. The percentage of correct predictions made from the β-thalassemia mutations and the XmnI SNP alone were significantly improved by the adjustment with the 3 other modifiers; from 73.6% to 83.2% (P<0.001). In this study, we showed that predictions based on genetic modifiers can foresee the Major or Intermedia type of β-thalassemia, even in cohorts of patients with various β-globin genotypes.

Heath-related quality of life in thyroid cancer patients following radioiodine ablation.

Abstract: There is limited information about the medium to long-term health-related quality of life (QOL) in thyroid cancer patients after initial therapy and the existing studies suffer from limitations. The aim of the study was to assess the determinants of medium-term QOL after the initial therapy. Following a total thyroidectomy, 88 thyroid cancer patients received either rhTSH or hypothyroid-assisted radioiodine ablation (RRA) using 3.7 GBq (100 mCi) of radioiodine. QOL evaluation of the patients using the validated Functional Assessment of Chronic Illness & Therapy (FACIT) was performed at the time of inclusion (t0) and later at the 9-month post-RRA (t1). 83 patients were eligible for the final evaluation. Medium-term FACIT scores were not statistically different between t0 and t1 patients. All but one domain of the QOL score was similar between t0 and t1. Using a multivariate analysis, only age and immediate postoperative QOL scores were found to be determinants of the overall medium term 9-month QOL scores. Analysis showed that 'high QOL levels' (baseline and 9-month) and 'no depression', 'low anxiety levels', were associated with '<45yrs', 'men', 'partner', and 'rhTSH stimulation'. The use of radioiodine ablation does not seem to affect the medium term QOL scores of patients. Medium-term QOL is mainly determined by pre-ablation QOL. The assessment of baseline QOL might be interesting to evaluate in order to adapt the treatment protocols, the preventive strategies, and medical information to patients for potentially improving their outcomes.

Valvular heart disease associated with benfluorex therapy: high prevalence in patients with unexplained restrictive valvular heart disease.

Abstract: Aims Restrictive valvular disease (RVD) has recently been reported in patients after benfluorex exposure. However, little is known about its prevalence and echocardiographic features. The aim of our study was to assess the frequency of benfluorex exposure in patients with RVD and to describe their echocardiographic characteristics. Methods and results In a single centre study, patients with a final diagnosis of unexplained RVD were studied. Patients were interrogated for their previous use of benfluorex or other appetite-suppressant drugs (ASDs). Forty seven consecutive patients, aged 59 ± 9.6 years, with RVD were found [42 (91%) women]. Among them, 35 (74%) had previous treatment with ASD, including benfluorex in 34 patients. Among the latter, 14 (40%) have been exposed to benfluorex alone, 20 (60%) in combination with another ASD. Echocardiographic features included isolated mitral or aortic restricted valve motion in 19 patients (40%), and combined mitral and aortic involvement in 28 (60%).Twenty-seven (96%) of the latter had been exposed to benfluorex. As compared with the ‘no ASD’ group ( n = 12), patients in the benfluorex group ( n = 34) were more frequently female, had more frequent arterial hypertension and hypertriglyceridemia, and presented more frequently with combined mitral and aortic disease (79 vs. 8%, P < 0.001). Valve stenosis and tricuspid involvement were rare in the benfluorex group. Conclusion The frequency of benfluorex exposure is high in patients with unexplained RVD. Combined aortic and mitral restrictive valve regurgitation is highly suggestive of valvular disease associated with benfluorex or other ASD therapy and may alert clinician about the possibility of this diagnosis.

Fractalkine expression induces endothelial progenitor cell lysis by natural killer cells.

Abstract: Background Circulating CD34(+) cells, a population that includes endothelial progenitors, participate in the maintenance of endothelial integrity. Better understanding of the mechanisms that regulate their survival is crucial to improve their regenerative activity in cardiovascular and renal diseases. Chemokine-receptor cross talk is critical in regulating cell homeostasis. We hypothesized that cell surface expression of the chemokine fractalkine (FKN) could target progenitor cell injury by Natural Killer (NK) cells, thereby limiting their availability for vascular repair. Methodology/principal findings We show that CD34(+)-derived Endothelial Colony Forming Cells (ECFC) can express FKN in response to TNF-α and IFN-γ inflammatory cytokines and that FKN expression by ECFC stimulates NK cell adhesion, NK cell-mediated ECFC lysis and microparticles release in vitro. The specific involvement of membrane FKN in these processes was demonstrated using FKN-transfected ECFC and anti-FKN blocking antibody. FKN expression was also evidenced on circulating CD34(+) progenitor cells and was detected at higher frequency in kidney transplant recipients, when compared to healthy controls. The proportion of CD34(+) cells expressing FKN was identified as an independent variable inversely correlated to CD34(+) progenitor cell count. We further showed that treatment of CD34(+) circulating cells isolated from adult blood donors with transplant serum or TNF-α/IFN-γ can induce FKN expression. Conclusions Our data highlights a novel mechanism by which FKN expression on CD34(+) progenitor cells may target their NK cell mediated killing and participate to their immune depletion in transplant recipients. Considering the numerous diseased contexts shown to promote FKN expression, our data identify FKN as a hallmark of altered progenitor cell homeostasis with potential implications in better evaluation of vascular repair in patients.

Validation française d’un questionnaire de qualité de vie des aidants naturels de patients schizophrènes

Abstract: Resume Objectif Nous decrivons ici les differentes etapes de la validation d’un autoquestionnaire d’evaluation de la qualite de vie des aidants naturels de patients souffrant de schizophrenie. Methodes Les items sont issus d’entretiens realises chez des aidants de patients schizophrenes pris en charge dans six centres hospitaliers en France (n = 246). La reduction d’items et l’etape de validation reposent sur l’analyse de distribution des reponses aux items et les analyses en composantes principales. Resultats La S-CGQoL contient 25 items decrivant sept dimensions (bien-etre psychologique et physique ; fardeau et vie quotidienne ; relations avec le conjoint ; relations avec l’equipe soignante ; relations avec la famille ; relations avec les amis et fardeau materiel). Son temps de passation est bref (cinq minutes). Cette structure explique 74,4 % de la variance totale. La coherence interne est satisfaisante, les coefficients alpha de Cronbach s’etendant de 0,79 a 0,92. Conclusion La S-CGQoL est un instrument auto-administre de qualite de vie qui presente des proprietes psychometriques satisfaisantes. Elle pourrait etre dans l’avenir un outil d’evaluation des prises en charge psychoeducationnelles destinees aux familles.

Triple-negative, low-grade gliomas: A highly agressive tumor with dismal prognosis.

Abstract: 2023 Background: The phenotypic heterogeneity of low-grade gliomas (LGGs) is still inconsistently explained by genetic alterations characteristic in patients treated according to present standards ...

TEMOBIC: A ANOCEF phase II study of BCNU and temozolomide (TMZ) combination prior to radiotherapy (RT) in anaplasic oligodendroglial gliomas (AOG).

Abstract: 2034 Background: Despite demonstrated chemosensitivity with PCV and TMZ, improvement of chemotherapy regimen need to be explored in AOG. Promising activity of BCNU and TMZ combination has been repo...

Functional and survival effect of bevacizumab and irinotecan administered at recurrence in a cohort of patients with GBM.

Abstract: 2087 Background: Bevacizumab (BEV) with or without irinotecan (IRI) have demonstrated activity in patients with recurrent GBM. However, survival benefit is debated. In order to explore clinical benefit and impact of BEV administration on survival, we analysed clinical outcome of patients treated with BEV +IRI in our institution, according to initial RPA classes, and recognized prognostic factors at recurrence. Methods: This single center retrospective cohort analysis included all patients with recurrent GBM treated with at least 1 cycle of BEV+IRI at our institution from April 2007 to May 2010, based on pharmacy charter. Overall survival was analysed from initial diagnosed of GBM (OS1) and from initiation of BEV+IRI (OS2). Progression free survival (PFS2) was analysed from initiation of BEV+IRI. Patients were assigned to RPA classes at the time of initial diagnosis as defined by Mirimanoff and col. (JCO, 2006) Results: 100 pts were identified, (M/F: 65/35), with a median age of 57.9 y (18-76). At the time...