Sylvie Chevret

Paris Diderot University, Lutetia Parisorum, Île-de-France, France

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Publications (450)2894.47 Total impact

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    ABSTRACT: Intensive care unit (ICU) admission is associated with high mortality in allogeneic hematopoietic stem cell transplant (HSCT) recipients. Whether mortality has decreased recently is unknown. The 497 adult allogeneic HSCT recipients admitted to three ICUs between 1997 and 2011 were evaluated retrospectively. Two hundred and nine patients admitted between 1997 and 2003 were compared with the 288 patients admitted from 2004 to 2011. Factors associated with 90-day mortality were identified. The recent cohort was characterized by older age, lower conditioning intensity, and greater use of peripheral blood or unrelated-donor graft. In the recent cohort, ICU was used more often for patients in hematological remission (67% vs 44%; P<0.0001) and without GVHD (73% vs 48%; P<0.0001) or invasive fungal infection (85% vs 73%; P=0.0003) despite a stable admission rate (21.7%). These changes were associated with significantly better 90-day survival (49% vs 31%). Independent predictors of hospital mortality were GVHD, mechanical ventilation (MV) and renal replacement therapy (RRT). Among patients who required MV or RRT, survival was 29% and 18%, respectively, but dropped to 18% and 6% in those with GVHD. The use of ICU admission has changed and translated into improved survival, but advanced life support in patients with GVHD usually provides no benefits.Bone Marrow Transplantation advance online publication, 23 March 2015; doi:10.1038/bmt.2015.55.
    Bone marrow transplantation 03/2015; DOI:10.1038/bmt.2015.55 · 3.00 Impact Factor
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    ABSTRACT: Various critical events, liver-related or not, occur in patients with compensated cirrhosis but their respective burden remain to be prospectively assessed. The aim of this prospective cohort study involving 35 French centres was to capture the whole spectrum of complications occurring in compensated viral cirrhosis using competing risks analyses. Inclusion criteria were: histologically proven cirrhosis due to HCV or HBV; Child-Pugh A; no previous hepatic complications. The cohort was considered as a multi-state disease model, cumulative incidences (CumI) of events were estimated in a competing risks framework. 1,654 patients were enrolled from 2006 to 2012 (HCV 1308, HBV 315, HCV-HBV 31). During a median follow-up of 34 months, at least one liver nodule was detected in 271 patients, confirmed as hepatocellular carcinoma (HCC) in 128 (4-yr cumI: 10.5%) and cholangiocarcinoma in 3. HCC incidence was higher in HCV (4-yr cumI: 11.4% vs. 7.4%, P=0.05). HCC fulfilled Milan criteria in 79.3%, leading to curative treatment in 70.4%. Liver decompensation occurred more frequently in HCV patients (4-yr cumI: 10.8% vs. 3.6%, P=0.0004). Virological eradication/control was achieved in 34.1% HCV and 88.6% HBV patients and was associated to a marked decrease in HCC, decompensation and bacterial infection incidences. Survival was shorter in HCV patients (4-yr cumI 91.6% vs. 97.2%, P=0.0002). Death (n=102, missing data 6) was attributed to liver disease in 48 (47%; liver cancer: n=18, miscellaneous: n=30) and to extra-hepatic causes in 48 (47%; bacterial infection n=13, extra-hepatic cancers n=10, cardiovascular events n=5, miscellaneous: n=20). Conclusion: After 3 years of follow-up, extra-hepatic events still explained half of deaths in patients with compensated viral cirrhosis. A strong decrease in complications was linked to virological eradication/control. This article is protected by copyright. All rights reserved. © 2015 by the American Association for the Study of Liver Diseases.
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    ABSTRACT: An increased proportion of deaths occur in the intensive care unit (ICU). We performed this prospective study in 41 ICUs to determine the prevalence and determinants of complicated grief after death of a loved one in the ICU. Relatives of 475 adult patients were followed up. Complicated grief was assessed at 6 and 12 months using the Inventory of Complicated Grief (cut-off score >25). Relatives also completed the Hospital Anxiety and Depression Scale at 3 months, and the Revised Impact of Event Scale for post-traumatic stress disorder symptoms at 3, 6 and 12 months. We used a mixed multivariate logistic regression model to identify determinants of complicated grief after 6 months. Among the 475 patients, 282 (59.4%) had a relative evaluated at 6 months. Complicated grief symptoms were identified in 147 (52%) relatives. Independent determinants of complicated grief symptoms were either not amenable to changes (relative of female sex, relative living alone and intensivist board certification before 2009) or potential targets for improvements (refusal of treatment by the patient, patient died while intubated, relatives present at the time of death, relatives did not say goodbye to the patient, and poor communication between physicians and relatives). End-of-life practices, communication and loneliness in bereaved relatives may be amenable to improvements. Copyright ©ERS 2015.
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    ABSTRACT: The prognosis of critically ill cancer patients has improved recently. Controversies remain as regard to the specific prognosis impact of neutropenia in critically ill cancer patients. The primary objective of this study was to assess hospital outcome of critically ill neutropenic cancer patients admitted into the ICU. The secondary objective was to assess risk factors for unfavorable outcome in this population of patients and specific impact of neutropenia. We performed a post hoc analysis of a prospectively collected database. The study was carried out in 17 university or university-affiliated centers in France and Belgium. Neutropenia was defined as a neutrophil count lower than 500/mm(3). Among the 1,011 patients admitted into the ICU during the study period 289 were neutropenic at the time of admission. Overall, 131 patients died during their hospital stay (hospital mortality 45.3 %). Four variables were associated with a poor outcome, namely allogeneic transplantation (OR 3.83; 95 % CI 1.75-8.35), need for mechanical ventilation (MV) (OR 6.57; 95 % CI 3.51-12.32), microbiological documentation (OR 2.33; CI 1.27-4.26), and need for renal replacement therapy (OR 2.77; 95 % CI 1.34-5.74). Two variables were associated with hospital survival, namely age younger than 70 (OR 0.22; 95 % CI 0.1-0.52) and neutropenic enterocolitis (OR 0.37; 95 % CI 0.15-0.9). A case-control analysis was also performed with patients of the initial database; after adjustment, neutropenia was not associated with hospital mortality (OR 1.27; 95 % CI 0.86-1.89). Hospital survival was closely associated with younger age and neutropenic enterocolitis. Conversely, need for conventional MV, for renal replacement therapy, and allogeneic hematopoietic stem cell transplantation (HSCT) were associated with poor outcome.
    Intensive Care Medicine 01/2015; 41(2). DOI:10.1007/s00134-014-3615-y · 5.54 Impact Factor
  • S Chevret, S Seaman, M Resche-Rigon
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    ABSTRACT: Missing values in clinical studies are almost unavoidable. When analyzing such data, the standard response is to exclude the patients with missing data. This is known as ‘complete case analysis’ (CCA) and has been shown to be the leading strategy in the epidemiology [1] and intensive care unit (ICU) literature [2]. However, if the excluded patients are not a representative subsample from the whole sample, their exclusion can lead to bias and loss of precision in estimation, both of which can, for example, adversely affect the performance of predictive risk models in the ICU (Supplementary 1). To deal with this issue, numerous imputation methods have been developed. The simplest method is “simple imputation.” This involves replacing each missing value with a single value, such as the mean of the observed data [3]. Thereafter, all patients present in the sample can be included in the analysis. The simplicity and ease of implementation of this method make it attractive. However, it tends ...
    Intensive Care Medicine 01/2015; 41(2). DOI:10.1007/s00134-014-3624-x · 5.54 Impact Factor
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    ABSTRACT: Improved mortality prediction for patients in intensive care units is a big challenge. Many severity scores have been proposed, but findings of validation studies have shown that they are not adequately calibrated. The Super ICU Learner Algorithm (SICULA), an ensemble machine learning technique that uses multiple learning algorithms to obtain better prediction performance, does at least as well as the best member of its library. We aimed to assess whether the Super Learner could provide a new mortality prediction algorithm for patients in intensive care units, and to assess its performance compared with other scoring systems. From January, 2001, to December, 2008, we used the Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC-II) database (version 26) including all patients admitted to an intensive care unit at the Beth Israel Deaconess Medical Centre, Boston, MA, USA. We assessed the calibration, discrimination, and risk classification of predicted hospital mortality based on Super Learner compared with SAPS-II, APACHE-II, and SOFA. We calculated performance measures with cross-validation to avoid making biased assessments. Our proposed score was then externally validated on a dataset of 200 randomly selected patients admitted at the intensive care unit of Hôpital Européen Georges-Pompidou, Paris, France, between Sept 1, 2013, and June, 30, 2014. The primary outcome was hospital mortality. The explanatory variables were the same as those included in the SAPS II score. 24 508 patients were included, with median SAPS-II of 38 (IQR 27-51) and median SOFA of 5 (IQR 2-8). 3002 of 24 508 (12%) patients died in the Beth Israel Deaconess Medical Centre. We produced two sets of predictions based on the Super Learner; the first based on the 17 variables as they appear in the SAPS-II score (SL1), and the second, on the original, untransformed variables (SL2). The two versions yielded average predicted probabilities of death of 0·12 (IQR 0·02-0·16) and 0·13 (0·01-0·19), whereas the corresponding value for SOFA was 0·12 (0·05-0·15) and for SAPS-II 0·30 (0·08-0·48). The cross-validated area under the receiver operating characteristic curve (AUROC) for SAPS-II was 0·78 (95% CI 0·77-0·78) and 0·71 (0·70-0·72) for SOFA. Super Learner had an AUROC of 0·85 (0·84-0·85) when the explanatory variables were categorised as in SAPS-II, and of 0·88 (0·87-0·89) when the same explanatory variables were included without any transformation. Additionally, Super Learner showed better calibration properties than previous score systems. On the external validation dataset, the AUROC was 0·94 (0·90-0·98) and calibration properties were good. Compared with conventional severity scores, Super Learner offers improved performance for predicting hospital mortality in patients in intensive care units. A user-friendly implementation is available online and should be useful for clinicians seeking to validate our score. Fulbright Foundation, Assistance Publique-Hôpitaux de Paris, Doris Duke Clinical Scientist Development Award, and the NIH. Copyright © 2014 Elsevier Ltd. All rights reserved.
    11/2014; 3(1). DOI:10.1016/S2213-2600(14)70239-5
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    ABSTRACT: A prospective phase II multicentric trial was performed to obtain less than 25% non-relapse mortality (NRM) after unrelated cord blood transplantation (UCBT) for adults with acute myeloid leukemia (AML) using reduced intensity conditioning regimen (RIC) consisting of total body irradiation (TBI 2Gy), cyclophosphamide (50mg/kg) and fludarabine (200mg/m2) (TCF). From 2007 to 2009, 79 UCBT recipients were enrolled. Patients transplanted in first complete remission (CR1) (n=48) had a higher frequency of unfavorable cytogenetics, secondary AML and greater number of induction courses of chemotherapy to achieve CR1 compared to the others. The median infused total nucleated cells (TNC) was 3.4 x107/kg; 60% received double UCBT; 77% were HLA mismatched (4/6) and 40% had major ABO-incompatibility. Cumulative incidence (CI) of neutrophil recovery at day-60 was 87% and CI of 100-day acute-GVHD (II-IV) was 50%. At 2-years, CI of NRM and relapse incidence were 20% and 46%, respectively. In a multivariate analysis, major ABO incompatibility (p=0.001) and TNC (<3.4x107/kg; p=0.001) were associated with increased NRM and use of 2 or more induction courses to obtain CR1 with increased relapse incidence (p=0.04). Leukemia-free survival (LFS) at 2-years was 35%, and the only factor associated with decreased LFS was secondary AML (p=0.04). In conclusion, despite the decreased NRM observed, other RIC regimens with higher myelosuppression should be evaluated to decrease relapse in high risk AML. (EUDRACT 2006-005901-67). Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
    Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation 11/2014; DOI:10.1016/j.bbmt.2014.11.009 · 3.15 Impact Factor
  • Leslie Pibouleau, Sylvie Chevret
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    ABSTRACT: Rationale: Bayesian methods provide an interesting approach to assessing an implantable medical device (IMD) that has evolved through successive versions because they allow for explicit incorporation of prior knowledge into the analysis. However, the literature is sparse on the feasibility and reliability of elicitation in cases where expert beliefs are used to form priors. Objectives: To develop an Internet-based method for eliciting experts' beliefs about the success rate of an intracranial stenting procedure and to assess their impact on the estimated benefit of the latest version. Study Design and Setting: The elicitation questionnaire was administered to a group of nineteen experts. Elicited experts' beliefs were used to inform the prior distributions of a Bayesian hierarchical meta-analysis model, allowing for the estimation of the success rate of each version.
    International Journal of Technology Assessment in Health Care 11/2014; 30(04):1-8. DOI:10.1017/S0266462314000403 · 1.56 Impact Factor
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    ABSTRACT: Agreement between two assays is usually based on the concordance correlation coefficient (CCC), estimated from the means, standard deviations, and correlation coefficient of these assays. However, such data will often suffer from left-censoring because of lower limits of detection of these assays. To handle such data, we propose to extend a multiple imputation approach by chained equations (MICE) developed in a close setting of one left-censored assay. The performance of this two-step approach is compared with that of a previously published maximum likelihood estimation through a simulation study. Results show close estimates of the CCC by both methods, although the coverage is improved by our MICE proposal. An application to cytomegalovirus quantification data is provided. Copyright © 2014 John Wiley & Sons, Ltd.
    Statistics in Medicine 10/2014; 33(30). DOI:10.1002/sim.6319 · 2.04 Impact Factor
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    ABSTRACT: Background & Aims: In cirrhosis, portal vein thrombosis (PVT) could be a cause or a consequence of the progression of liver disease. We analyzed data from a prospective trial of ultrasound screening for hepatocellular carcinoma in order to identify risk factors for, and the impact of PVT in patients with cirrhosis.Methods: 1243 adults with cirrhosis without PVT were enrolled from 43 liver units in France and Belgium, between June 2000 and March 2006. Mean follow-up was 47 months. Doppler ultrasonography was used to check portal vein. Progression of liver disease was defined by the development of: ascites, hepatic encephalopathy, variceal bleeding, prothrombin <45%, serum bilirubin >45 μmol/L, albumin <28 g/L, and/or creatinine >115 μmol/L. G20210A prothrombin and factor V gene mutations were assessed in sera stored in 3 large centers.Results: Five-year cumulative incidence of PVT was 10.7%. PVT was mostly partial and varied over time. The development of PVT was independently associated with baseline esophageal varices (P = 0.01) and prothrombin time (P = 0.002), but not with disease progression before PVT, or prothrombotic mutations. Disease progression was independently associated with baseline age (HR 1.55; 95%CI 1.11-2.17), body mass index (HR 1.40; 95%CI 1.01-1.95), prothrombin time (HR 0.79; 95%CI 0.70-0.90), serum albumin (HR 0.97; 95%CI 0.94-0.99), and esophageal varices (HR 1.70; 95%CI 1.21-2.38) but not with the prior development of PVT (HR 1.32; 95%CI 0.68-2.65).Conclusions: In patients with cirrhosis, the development of PVT is associated with the severity of liver disease at baseline, but does not follow a recent progression of liver disease. There is no evidence that the development of PVT is responsible for further progression of liver disease. (Hepatology 2014;)
    Hepatology 10/2014; 61(2). DOI:10.1002/hep.27546 · 11.19 Impact Factor
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    ABSTRACT: Background Various late-onset noninfectious pulmonary complications may occur after allogeneic hematopoietic stem cell transplantation (HSCT). Interstitial lung diseases (ILD) are often overlooked, and few data are available. Methods We retrospectively analyzed the clinical features, pulmonary function tests, radiological features and outcomes of allogeneic HSCT recipients who were diagnosed with a noninfectious ILD and were managed in our center between 2001 and 2010. Results Forty patients were analyzed. The median time from transplant to ILD was 11.3 months. The donor hematopoietic stem cell source was peripheral blood stem cells in 75% of the cases. Seventy percent of the patients had extra-thoracic chronic graft versus host disease at ILD diagnosis. We identified two lung computed tomography (CT) scan patterns according to the predominance of ground glass opacities or alveolar consolidations. Restrictive ventilatory defect was the main pulmonary function pattern. Lung histology was available for seven patients and showed diffuse alveolar damage, non-specific interstitial pneumonia, organizing pneumonia or lymphoid interstitial pneumonia. Thirty-five patients (87.5%) were treated with systemic steroids. Thirteen patients died (32.5%), 10 of respiratory failure. The median survival rate at 24 months was 61%. Conclusion This study highlights the existence of noninfectious post-allogeneic HSCT ILD and provides new insights into the characteristics of these illnesses.
    Respiratory Medicine 09/2014; 108(10). DOI:10.1016/j.rmed.2014.09.006 · 2.92 Impact Factor
  • M. Resche-Rigon, S. Chevret
    Revue d Épidémiologie et de Santé Publique 08/2014; 62:S131-S132. DOI:10.1016/j.respe.2014.05.043 · 0.66 Impact Factor
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    ABSTRACT: We sought to identify risk factors for mechanical ventilation in patients with malignancies and acute respiratory failure (ARF).
    Respiratory care 07/2014; DOI:10.4187/respcare.02693 · 1.84 Impact Factor
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    ABSTRACT: We analysed the prognostic significance of minimal residual disease (MRD) level in adult patients with acute myeloid leukemia (AML) treated in the randomized gemtuzumab ozogamicin (GO) ALFA-0701 trial. Levels of WT1 and NPM1 gene transcripts were assessed using cDNA-based real-time quantitative PCR in 183 patients with WT1 overexpression and in 77 patients with NMP1 mutation (NPM1mut) at diagnosis. Positive WT1 MRD (defined as > 0.5% in the peripheral blood) after induction and at the end of treatment were both significantly associated with a higher risk of relapse and a shorter overall survival (OS). Positive NPM1mut MRD (defined as > 0.1% in the bone marrow) after induction and at the end of treatment also predicted a higher risk of relapse, but did not influence OS. Interestingly, the achievement of a negative NPM1mut MRD was significantly more frequent in patients treated in the GO arm compared to those treated in control arm (39 % versus 7% (p=0.006) after induction and 91% versus 61% (p=0.028) at the end of treatment). However, GO did not influence WT1 MRD levels. Our study supports the prognostic significance of MRD assessed by WT1 and NPM1mut transcript levels and show that NPM1 MRD is decreased by GO treatment.
    Oncotarget 07/2014; 5(15). · 6.63 Impact Factor
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    ABSTRACT: Gemtuzumab ozogamicin was the first example of antibody-directed chemotherapy in cancer, and was developed for acute myeloid leukaemia. However, randomised trials in which it was combined with standard induction chemotherapy in adults have produced conflicting results. We did a meta-analysis of individual patient data to assess the efficacy of adding gemtuzumab ozogamicin to induction chemotherapy in adult patients with acute myeloid leukaemia.
    The Lancet Oncology 07/2014; 15(9). DOI:10.1016/S1470-2045(14)70281-5 · 25.12 Impact Factor
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    ABSTRACT: Background Kidney transplant recipients are at risk for life-threatening infections, which may affect the long-term prognosis.Methods We retrospectively included all kidney transplant recipients admitted for sepsis, severe sepsis, or septic shock to the medical intensive care unit (ICU) of the Saint-Louis Hospital, Paris, France, between 2000 and 2010. The main objective was to identify factors associated with survival without graft impairment 90 days after ICU discharge.ResultsData were available for 83 of 100 eligible patients. The main sites of infection were the lungs (54%), urinary tract (24%), and bloodstream (22%). Among documented infections (55/83), 80% were bacterial. Fungal infections were more common among patients transplanted after 2005 (5% vs. 23%, P = 0.02). Mechanical ventilation was used in 46 (56%) patients, vasopressors in 39 (47%), and renal replacement therapy (RRT) in 34 (41%). In-hospital and day-90 mortality rates were 20% and 22%, respectively. On day 90, among the 65 survivors, 39 (47%) had recovered their previous graft function and 26 (31%) had impaired graft function, including 16 (19%) who were dependent on RRT. Factors independently associated with day-90 survival and graft function recovery were baseline serum creatinine (odds ratio [OR] for a 10 μmol/L increase 0.94, 95% confidence interval [CI] 0.88–1.00) and cyclosporine therapy (OR 0.30, 95% CI 0.11–0.79).Conclusion Sepsis was chiefly related to bacterial pneumonia or urinary tract infection. Pneumocystis jirovecii was the leading opportunistic agent, with a trend toward an increase over time. Infections often induced severe graft function impairment. Baseline creatinine and cyclosporine therapy independently predicted the outcome.
    Transplant Infectious Disease 06/2014; 16(4). DOI:10.1111/tid.12249 · 1.98 Impact Factor
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    ABSTRACT: With intensified pediatric-like therapy and genetic disease dissection, the field of adult acute lymphoblastic leukemia (ALL) has evolved recently. In this new context, we aimed to reassess the value of conventional risk factors with regard to new genetic alterations and early response to therapy, as assessed by Ig/TCR minimal residual disease (MRD) levels. The study was performed in 423 younger adults with Philadelphia chromosome-negative ALL in first remission (265 B-cell precursor [BCP] and 158 T-cell ALL), with cumulative incidence of relapse (CIR) as primary endpoint. In addition to conventional risk factors, the most frequent currently available genetic alterations were included in the analysis. A higher specific hazard of relapse was independently associated with post-induction MRD level ≥ 10(-4) and unfavorable genetic characteristics (i.e. MLL gene rearrangement or focal IKZF1 gene deletion in BCP-ALL; and no NOTCH1/FBXW7 mutation and/or N/K-RAS mutation and/or PTEN gene alteration in T-ALL). These two factors allowed definition of a new risk classification, which is strongly associated with higher CIR and shorter relapse-free and overall survival. These results indicate that genetic abnormalities are important predictors of outcome in adult ALL, not fully recapitulated by early response to therapy. Patients included in this study were treated in the multicenter GRAALL-2003 and 2005 trials. Both trials were registered at (GRAALL-2003, NCT00222027; GRAALL-2005, NCT00327678).
    Blood 04/2014; 123(24). DOI:10.1182/blood-2014-01-547695 · 9.78 Impact Factor
  • Djillali Annane, Sylvie Chevret
    JAMA The Journal of the American Medical Association 03/2014; 311(10):1069-70. DOI:10.1001/jama.2014.841 · 29.98 Impact Factor
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    ABSTRACT: We recently showed that the addition of fractionated doses of gemtuzumab ozogamicin (GO) to standard chemotherapy improves clinical outcome of acute myeloid leukemia (AML) patients. In the present study, we performed mutational analysis of 11 genes (FLT3, NPM1, CEBPA, MLL, WT1, IDH1/2, RUNX1, ASXL1, TET2, DNMT3A), EVI1 overexpression screening, and 6.0 single-nucleotide polymorphism array (SNP-A) analysis in diagnostic samples of the 278 AML patients enrolled in the ALFA-0701 trial. In cytogenetically normal (CN) AML (n=146), 38% of the patients had at least 1 SNP-A lesion and 89% of the patients had at least 1 molecular alteration. In multivariate analysis, the independent predictors of higher cumulative incidence of relapse were unfavorable karyotype (P = 0.013) and randomization in the control arm (P = 0.007) in the whole cohort, and MLL partial tandem duplications (P = 0.014) and DNMT3A mutations (P = 0.010) in CN-AML. The independent predictors of shorter overall survival (OS) were unfavorable karyotype (P <0.001) and SNP-A lesion(s) (P = 0.001) in the whole cohort, and SNP-A lesion(s) (P = 0.006), DNMT3A mutations (P = 0.042) and randomization in the control arm (P = 0.043) in CN-AML. Interestingly, CN-AML patients benefited preferentially more from GO treatment as compared to AML patients with abnormal cytogenetics (hazard ratio for death, 0.52 versus 1.14; test for interaction, P = 0.04). Although the interaction test was not statistically significant, the OS benefit associated with GO treatment appeared also more pronounced in FLT3 internal tandem duplication positive than in negative patients.
    Oncotarget 01/2014; · 6.63 Impact Factor
  • Jérôme Lambert, Sylvie Chevret
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    ABSTRACT: Assessments of the discriminative performance of prognostic models have led to the development of several measures that extend the concept of discrimination as evaluated by the receiver operating characteristics curve and the area under the receiver operating characteristic curve (AUC) of diagnostic settings. Thus, several time-dependent-receiver operating characteristic curve and AUC(t) have been proposed. One of the most used, the cumulative/dynamic AUC(C,D)(t) is the probability that, given two randomly chosen patients, one having failed before t and the other having failed after t, the prognostic marker will be correctly ranked. In this paper, we propose a weighted AUC(C,D)(t) with time- and data-dependent weights as a summary measure of the mean AUC(C,D)(t), restricted to a finite time range to ensure its clinical relevance. A simulation study shows that estimated restricted mean AUC increased with the strength of association of the covariate with the outcome, with low impact of censoring, and adequate coverage of bootstrap confidence intervals. We illustrate this methodology to two real datasets from two randomized clinical trials to assess the prognostic factors of the overall mortality in patients who have compensated cirrhosis and to assess the prognostic factors of event-free survival in patients who have acute myeloid leukemia.
    Statistical Methods in Medical Research 01/2014; DOI:10.1177/0962280213515571 · 2.96 Impact Factor

Publication Stats

17k Citations
2,894.47 Total Impact Points


  • 2008–2014
    • Paris Diderot University
      Lutetia Parisorum, Île-de-France, France
    • Centre Hospitalier Universitaire d'Angers
      • Département de neurologie
      Angers, Pays de la Loire, France
    • Institut de Cancérologie Gustave Roussy
      • Department of Radiotherapy
      Île-de-France, France
  • 2004–2014
    • Université de Versailles Saint-Quentin
      Versailles, Île-de-France, France
    • Centre Hospitalier Régional Universitaire de Lille
      Lille, Nord-Pas-de-Calais, France
    • Centre Hospitalier de Versailles
      • Department of Onco-Hematology
      Versailles, Île-de-France, France
  • 2002–2014
    • Unité Inserm U1077
      Caen, Lower Normandy, France
    • University of Helsinki
      Helsinki, Uusimaa, Finland
    • Centre Hospitalier Universitaire Rouen
      Rouen, Haute-Normandie, France
  • 1992–2014
    • Université René Descartes - Paris 5
      Lutetia Parisorum, Île-de-France, France
    • Institut National de la Transfusion Sanguine, Paris
      Lutetia Parisorum, Île-de-France, France
  • 2013
    • Centre Hospitalier Régional Universitaire de Nîmes
      Nismes, Languedoc-Roussillon, France
  • 1994–2013
    • Hôpital Raymond-Poincaré – Hôpitaux universitaires Paris Ile-de-France Ouest
      Garches, Île-de-France, France
  • 2012
    • Hôpital Saint-Louis (Hôpitaux Universitaires Saint-Louis, Laboisière, Fernand-Widal)
      • Service de Pneumologie
      Paris, Ile-de-France, France
  • 2011
    • Centre Hospitalier Universitaire de Saint-Étienne
      Saint-Étienne, Rhône-Alpes, France
    • French Institute of Health and Medical Research
      Lutetia Parisorum, Île-de-France, France
    • University Joseph Fourier - Grenoble 1
      • Institut Albert Bonniot
      Grenoble, Rhône-Alpes, France
  • 2007–2011
    • University of Paris-Est
      La Haye-Descartes, Centre, France
    • University of Washington Seattle
      Seattle, Washington, United States
    • Centre Hospitalier Universitaire de Nancy
      Nancy, Lorraine, France
    • Hôpitaux Universitaires La Pitié salpêtrière - Charles Foix
      Lutetia Parisorum, Île-de-France, France
  • 2010
    • Sunnybrook Health Sciences Centre
      • Department of Critical Care Medicine
      Toronto, Ontario, Canada
    • University of Limoges
      Limages, Limousin, France
  • 2003–2010
    • Assistance Publique – Hôpitaux de Paris
      Lutetia Parisorum, Île-de-France, France
    • Clinique Ambroise Paré
      Tolosa de Llenguadoc, Midi-Pyrénées, France
  • 2009
    • Pierre and Marie Curie University - Paris 6
      Lutetia Parisorum, Île-de-France, France
  • 2005–2009
    • Université Paris 13 Nord
      Île-de-France, France
    • Hôpital Henri Mondor (Hôpitaux Universitaires Henri Mondor)
      Créteil, Île-de-France, France
  • 2003–2007
    • Mercy Hospital St. Louis
      San Luis, Missouri, United States
  • 2006
    • University of Glasgow
      Glasgow, Scotland, United Kingdom
  • 2001–2006
    • Université Paris-Est Créteil Val de Marne - Université Paris 12
      Créteil, Île-de-France, France
    • Centre Hospitalier Universitaire de Caen
      Caen, Lower Normandy, France
    • American Hospital of Paris
      Lutetia Parisorum, Île-de-France, France
    • University of Hamburg
      Hamburg, Hamburg, Germany
  • 1999–2003
    • Hôpital Bichat - Claude-Bernard (Hôpitaux Universitaires Paris Nord Val de Seine)
      • Service de Réanimation Médicale et des Maladies Infectieuses
      Lutetia Parisorum, Île-de-France, France
  • 2000–2002
    • Hôpital Antoine-Béclère – Hôpitaux universitaires Paris-Sud
      Clamart, Île-de-France, France
  • 1999–2002
    • Hôpital La Pitié Salpêtrière (Groupe Hospitalier "La Pitié Salpêtrière - Charles Foix")
      • Service d’Hépato - Gastro - Entérologie
      Lutetia Parisorum, Île-de-France, France
  • 1992–2002
    • Hôpital Paris Saint Joseph
      Lutetia Parisorum, Île-de-France, France
  • 1998
    • Hôpital Cochin (Hôpitaux Universitaires Paris Centre)
      Lutetia Parisorum, Île-de-France, France
  • 1996
    • Hôtel-Dieu de Paris – Hôpitaux universitaires Paris Centre
      Lutetia Parisorum, Île-de-France, France