J Landman-Parker

Publications (44)252.7 Total impact

• Article: Expression of CD34 and CD7 on human T-cell acute lymphoblastic leukemia discriminates functionally heterogeneous cell populations.

  B Gerby, E Clappier, F Armstrong, C Deswarte, J Calvo, S Poglio, J Soulier, N Boissel, T Leblanc, A Baruchel, J Landman-Parker, P H Roméo, P Ballerini, F Pflumio
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  ABSTRACT: Leukemia-initiating/repopulating cells (LICs), also named leukemic stem cells, are responsible for propagating human acute leukemia. Although they have been characterized in various leukemias, their role in T-cell acute lymphoblastic leukemia (T-ALL) is unclear. To identify and characterize LICs in T-ALL (T-LIC), we fractionated peripheral blood cell populations from patient samples by flow cytometry into three cell fractions by using two markers: CD34 (a marker of immature cells and LICs) and CD7 (a marker of early T-cell differentiation). We tested these populations in both in vitro culture assays and in vivo for growth and leukemia development in immune-deficient mice. We found LIC activity in CD7(+) cells only as CD34(+)CD7(-) cells contained normal human progenitors and hematopoietic stem cells that differentiated into T, B lymphoid and myeloid cells. In contrast, CD34(+)CD7(+) cells were enriched in LICs, when compared with CD34(-)CD7(+) cells. These CD34(+)CD7(+) cells also proliferated more upon NOTCH activation than CD34(-)CD7(+) cells and were sensitive to dexamethasone and NOTCH inhibitors. These data show that CD34 and CD7 expression in human T-ALL samples help in discriminating heterogeneous cell populations endowed with different LIC activity, proliferation capacity and responses to drugs.
  Leukemia: official journal of the Leukemia Society of America, Leukemia Research Fund, U.K 05/2011; 25(8):1249-58. · 8.30 Impact Factor
• Article: [Hodgkin disease and autoimmunity in children: 11 case reports].

  C Jarrassé, A Pagnier, C Edan, J Landman-Parker, F Mazingue, L Mansuy, Y Bertrand, C Paillard, I Pellier, G Margueritte, D Plantaz
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  ABSTRACT: The association of lymphoma and autoimmune manifestations has been predominantly studied in adults affected by non-Hodgkin lymphoma. Few publications exist in the literature concerning Hodgkin lymphoma, particularly in children and adolescents. The objectives of this study were to define the characteristics of the link between Hodgkin disease and autoimmunity in childhood. The present 25-year retrospective study was conducted in all centers affiliated with the French Society of Paediatric Oncology (SFCE). Eleven children with Hodgkin disease presented manifestations of disimmunity preceding or following their diagnosis. Four patients had thrombocytopenic purpura, the remaining 7 each had a different autoimmune pathology: lupus syndrome, antiphospholipid syndrome with transient ischemic attack, Evans syndrome, leukocytoclastic vasculitis, autoimmune hemolytic anemia, autoimmune thyroiditis, and juvenile idiopathic arthritis. Lymphoma relapse occurred in 3 patients. Two children died, death being directly attributed to the autoimmune disease in 1 case. Our data suggest that development of autoimmunity is related to significant morbidity. Possible pathophysiological mechanisms include lymphocyte proliferation secondary to chronic inflammation, cell-mediated immune deficiency in Hodgkin disease, molecular mimetics, and antineoplastic phenomena are discussed. A study with a larger patient population is needed to identify the group of children at high risk of autoimmunity for whom additional investigations and modified therapy may be indicated.
  Archives de Pédiatrie 03/2011; 18(4):376-82. · 0.30 Impact Factor
• Article: [Is there a risk of steroid-induced adrenal deficit after induction treatment of acute lymphoblastic leukemia?].

  V Bélien-Pallet, S Cabrol, S Fasola, A Petit, J Landman-Parker, A Auvrignon, G Leverger
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  ABSTRACT: The occurrence of eight cases of adrenal deficit in children hospitalized for acute lymphoblastic leukemia (ALL) led us to conduct a prospective study from May 2006 to May 2007 to better characterize this corticoid-induced adrenal deficit. Forty of the 48 patients hospitalized for ALL were given a low-dose Synacthen test (1 μg), a mean 7 days after the induction phase. An adrenal deficit was diagnosed in 27 patients (67.5%). No significant clinical or hematological difference was identified between the "with deficit" (n = 27) and "without deficit" (n = 13) groups. The diagnosis of adrenal deficit was not more common for children who had received dexamethasone (13/19) or prednisone (14/21), or for those who had (19/29) or had not (8/11) experienced corticoid toxicity during induction. The clinical signs suggesting adrenal deficit were identical in the two groups and none of the children presented an acute episode. In biological terms, only hypoprotidemia was significantly more common in patients with adrenal deficit (p = 0.0004). Of 13 patients with a deficit at the end of the induction who had received a 2nd low-dose Synacthène(®) test before intensification no. 1, 3 weeks on average after the end of corticotherapy, only two still had a deficit. Thus, corticoid-induced adrenal deficit is a common complication in children treated for ALL, although it is not highly symptomatic. Most of these children recover normal adrenal function before intensification no. 1, but it does not eliminate the risk of a secondary deficit after other courses of corticotherapy. Systematic repeated Synacthène(®) tests in common practice among children treated for ALL does not seem justified. However, the results of this study encouraged us to propose a hydrocortisone substitution to children treated for ALL in the event of stress.
  Archives de Pédiatrie 10/2010; 17(12):1637-44. · 0.30 Impact Factor
• Article: [Inherited thrombocytopenias].

  G Leverger, A Petit, S Fasola, J Landman-Parker, R Favier
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  ABSTRACT: Secondary causes of thrombocytopenia as immunologic thrombopenia purpura, or ITP, are far more common than inherited causes, which even as a group, are rare. Nevertheless, diagnosis is important and progress made in uncovering the molecular basis of these disorders has contributed greatly to our knowledge of these diseases. Inherited thrombocytopenias are a heterogeneous group of disorders. Different criteria have been suggested to classify the forms, such as the inheritance mechanism and the platelet volume as well as the associated platelet dysfunctions or clinical abnormality. This paper describes the clinical and biological data, and current knowledge of the molecular findings of inherited thrombocytopenia, allowing a diagnostic approach to these diseases.
  Archives de Pédiatrie 08/2010; 17(8):1185-91. · 0.30 Impact Factor
• Article: Optimized gene transfer into human primary leukemic T cell with NOD-SCID/leukemia-initiating cell activity.

  B Gerby, F Armstrong, P B de la Grange, H Medyouf, J Calvo, E Verhoeyen, F L Cosset, I Bernstein, S Amselem, N Boissel, H Dombret, T Leblanc, A Baruchel, J Landman-Parker, P Ballerini, F Pflumio
  Leukemia: official journal of the Leukemia Society of America, Leukemia Research Fund, U.K 11/2009; 24(3):646-9. · 8.30 Impact Factor
• Article: Extensive mutational status of genes and clinical outcome in pediatric acute myeloid leukemia.

  H Lapillonne, L Llopis, A Auvrignon, A Renneville, M Labopin, F Mazingue, C Perot, J-L Lai, N Philippe, P Ballerini, V Zurawski, M Adam, L Douay, G Leverger, J Landman-Parker, C Preudhomme
  Leukemia: official journal of the Leukemia Society of America, Leukemia Research Fund, U.K 09/2009; 24(1):205-9. · 8.30 Impact Factor
• Source

  Available from: pnas.org

  Article: Mutations in NALP12 cause hereditary periodic fever syndromes.

  I Jéru, P Duquesnoy, T Fernandes-Alnemri, E Cochet, J W Yu, M Lackmy-Port-Lis, E Grimprel, J Landman-Parker, V Hentgen, S Marlin, K McElreavey, T Sarkisian, G Grateau, E S Alnemri, S Amselem
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  ABSTRACT: NALP proteins, also known as NLRPs, belong to the CATERPILLER protein family involved, like Toll-like receptors, in the recognition of microbial molecules and the subsequent activation of inflammatory and immune responses. Current advances in the function of NALPs support the recently proposed model of a disease continuum bridging autoimmune and autoinflammatory disorders. Among these diseases, hereditary periodic fevers (HPFs) are Mendelian disorders associated with sequence variations in very few genes; these variations are mostly missense mutations whose deleterious effect, which is particularly difficult to assess, is often questionable. The growing number of identified sporadic cases of periodic fever syndrome, together with the lack of discriminatory clinical criteria, has greatly hampered the identification of new disease-causing genes, a step that is, however, essential for appropriate management of these disorders. Using a candidate gene approach, we identified nonambiguous mutations in NALP12 (i.e., nonsense and splice site) in two families with periodic fever syndromes. As shown by means of functional studies, these two NALP12 mutations have a deleterious effect on NF-kappaB signaling. Overall, these data identify a group of HPFs defined by molecular defects in NALP12, opening up new ways to manage these disorders. The identification of these first NALP12 mutations in patients with autoinflammatory disorder also clearly demonstrates the crucial role of NALP12 in inflammatory signaling pathways, thereby assigning a precise function to this particular member of an emerging family of proteins whose putative biological properties are currently inferred essentially through in vitro means.
  Proceedings of the National Academy of Sciences 03/2008; 105(5):1614-9. · 9.68 Impact Factor
• Article: The CALM-AF10 fusion is a rare event in acute megakaryoblastic leukemia.

  O Greiner, B C Bornhauser, E Delabesse, P Ballerini, J Landman-Parker, J P Bourquin
  Leukemia: official journal of the Leukemia Society of America, Leukemia Research Fund, U.K 01/2008; 21(12):2568-9. · 8.30 Impact Factor
• Article: Age and high-dose methotrexate are associated to clinical acute encephalopathy in FRALLE 93 trial for acute lymphoblastic leukemia in children.

  M N Dufourg, J Landman-Parker, M F Auclerc, C Schmitt, Y Perel, G Michel, P Levy, G Couillault, V Gandemer, M D Tabone, F Demeocq, J P Vannier, T Leblanc, G Leverger, A Baruchel
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  ABSTRACT: The objective of the study was to assess acute neurotoxicity associated with triple intrathecal therapy (TIT)+/-high-dose methotrexate (HD MTX) in children with acute lymphoblastic leukemia (ALL). 1395 children were enrolled on FRALLE 93 protocol from 1993 to 1999. Lower-risk group (LR, n=182) were randomized to weekly low-dose MTX at 25 mg/m(2)/week (LD MTX, n=81) or HD MTX at 1.5 g/m(2)/2 weeks x 6 (n=77). Intermediate-risk group (IR, n=672) were randomized to LD MTX (n=290) or HD MTX at 8 g/m(2)/2 weeks x 4 (n=316). Higher-risk group (HR, n=541) prednisone-responder patients received LD MTX and cranial radiotherapy. HR group steroid resistant cases were grafted (autologous or allogenic). TIT (MTX, cytarabine and methylprednisolone) was given every 2 weeks during 16-18 weeks and every 3 months during maintenance therapy in LR and IR patients. 52 patients (3.7%) developed neurotoxicity. Isolated seizures: n=15 (1.1%), peripheral and spinal neuropathy: n=17 (1.2%) and encephalopathy: n=20 (1.4%). Age >10 years was significantly associated with neurotoxicity (P=0.01) and use of HD MTX is associated with encephalopathy (P=0.03). Sequels are reported respectively in 60 and 33% of spinal neuropathy and encephalopathy cases. Current strategies tailoring risk of neurological sequels has to be defined.
  Leukemia 03/2007; 21(2):238-47. · 9.56 Impact Factor
• Article: Most immature T-ALLs express Ra-IL3 (CD123): possible target for DT-IL3 therapy.

  L Lhermitte, A de Labarthe, C Dupret, H Lapillonne, C Millien, J Landman-Parker, O Hermine, A Baruchel, F Sigaux, E Macintyre, V Asnafi
  Leukemia 11/2006; 20(10):1908-10. · 9.56 Impact Factor
• Article: Impact d’une leucémie aiguë lymphoblastique (LAL) survenue dans l’enfance sur des adolescents aujourd’hui guéris

  N. Trocmé, G. Vaudre, J. Landman-Parker, C. Dollfus, G. Leverger
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  ABSTRACT: Comment se sont inscrits pour les adolescents, dans l’après-coup d’une maladie potentiellement létale comme la LAL, les moments clés tels que l’annonce du diagnostic, l’hospitalisation et les traitements longs, invasifs et douloureux qu’ils ont subis? Plus de onze ans après (temps médian de rémission), les traces du traumatisme qu’elle a engendré sont perceptibles chez la plupart d’entre eux. Dans l’après-coup, ce qui les a le plus marqué et revient le plus souvent reste pour 63 % d’entre eux une souffrance psychologique. Bien que pour la majorité la guérison soit acquise, la crainte d’une rechute persiste encore pour un tiers d’entre eux. Même si 90 % disent avoir une vie agréable, 56 % ne souhaitent pas reparler de la maladie car elle est un moment douloureux. Ils témoignent aussi de changements dans leur famille, consécutifs à la maladie. La majorité des adolescents disent se sentir «comme les autres» et revendiquent des projets d’avenir, mais le dépassement du vécu douloureux de la maladie reste fragile. How have adolescents and young adults, cured of acute lymphoblastic leukaemia, endured the onset of and lived with a childhood disease that threatened cancer-related death. More specifically, we wanted to focus on experiences related to communication of the diagnosis, hospitalisation and treatment, and the consequences of their social, psychological and physical behaviour. After 11 years of disease, the effects of the trauma can be seen in most of these young patients. Today, psychological pain is most often reported, 63% of them indicating persistent psychological and health consequences when interviewed; in some cases, their current condition interferes with daily life. In themajority of cases, they consider themselves cured, but want to continue regular medical evaluations. Fear of remission persists in a third of these individuals. Ninety percent are satisfied with their lives, although 56% dislike talking about leukaemia. They also indicate that the disease has an impact on their family life. Most of these patients believe themselves to be “like everyone else” and develop long-term projects, but overcoming the painful experience of the disease remains difficult.
  Revue Francophone de Psycho-Oncologie 08/2006; 5(3):170-175.
• Article: [How to discuss death with a dying child: a story can help?].

  A Auvrignon, S Fasola, C Loedec, C Aumont, S Nomdedeu, J Landman-Parker, S Gervaise, G Vaudre, S Renolleau, G Leverger
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  ABSTRACT: Is it necessary - and possible - to discuss death with a child in palliative phase? How should one approach the subject? A recent Swedish study demonstrated the benefits for parents who discussed with their child his or her imminent death, and raised the question of the role nursing can play to help parents. The mother of one child treated in our unit recently wrote a story 48 hours before the child's death. The story served to broach a number of recurrent questions often raised by dying children and their families: fear of the unknown, of being replaced, the inevitability of death, grief, and fear of being forgotten... The story was given to 13 families with dying children. In order to evaluate the story's impact on families and to determine whether a document which stimulates dialogue should continue to be given to parents, we asked that they fill out a questionnaire. Fifty-five percent of parents answered, and confirmed that the story was experienced as a positive thing and helped parents to talk with their children. This study raises many questions and should be part of a global accompaniment strategy. A review of medical, general and children's literature, as well the results of our study, lead us to conclude that the medical body should lend its full support to families who wish to engage in this dialogue with their children.
  Archives de Pédiatrie 06/2006; 13(5):488-500. · 0.30 Impact Factor
• Article: Treatment of childhood acute myeloblastic leukemia: dose intensification improves outcome and maintenance therapy is of no benefit--multicenter studies of the French LAME (Leucémie Aiguë Myéloblastique Enfant) Cooperative Group.

  Y Perel, A Auvrignon, T Leblanc, G Michel, Y Reguerre, J-P Vannier, J-H Dalle, V Gandemer, C Schmitt, F Méchinaud, O Lejars, C Piguet, G Couillaud, B Pautard, J Landman-Parker, I Thuret, N Aladjidi, A Baruchel, G Leverger
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  ABSTRACT: From 1989 to 1998, 341 children were included in the French multicentric LAME (Leucémie Aiguë Myéloblastique Enfant) trials. A total of 309 children were registered in the LAME 89/91 protocol. This intensive regimen included an induction phase (mitoxantrone plus cytarabine), two consolidation courses, one containing timed-sequential high-dose cytarabine, asparaginase and amsacrine; 276 (90%) achieved a CR. The 5-year overall survival (OS) and event-free survival (EFS) were 60+/-4 and 48+/-4%, respectively. From 1997, timed-sequencing of the LAME SP induction chemotherapy led to an unacceptable frequency of consolidation delay; future improvements are unlikely to come from further increases in intensity. The role of allogenic bone-marrow transplantation from an HLA-identical sibling in CR1 was examined. The disease-free survival (DFS) was 52+/-4% for non-allografted patients and 57+/-7% for allografted patients (P=NS); a better OS for allografted patients was shown and could be related either to allo-BMT early in CR1 or to a second allo-BMT in CR2. For the complete responders after consolidation therapy, the 5-year OS was significantly better in patients randomized for no maintenance therapy (MT-) than in patients randomized for MT (77.6+/-8 vs 59+/-8%; P=0.05), while the 5-year DFS was not significantly different. Exposure to low-dose MT might contribute to clinical drug resistance and treatment failure in relapsing patients.
  Leukemia 01/2006; 19(12):2082-9. · 9.56 Impact Factor
• Article: Multi-centre pilot study of 2-chlorodeoxyadenosine and cytosine arabinoside combined chemotherapy in refractory Langerhans cell histiocytosis with haematological dysfunction.

  F Bernard, C Thomas, Y Bertrand, M Munzer, J Landman Parker, M Ouache, V Minard Colin, Y Perel, P Chastagner, C Vermylen, J Donadieu
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  ABSTRACT: The aim of this study was to assess the efficacy and adverse effects of 2-chlorodeoxyadenosine (2-CdA) and cytosine arabinoside (Ara-C) in children with refractory Langerhans cell histiocytosis (LCH) and haematopoietic dysfunction. Ten patients, with a median age at diagnosis of 0.5 years, were enrolled in this study. Treatment comprised at least two courses of Ara-C (1000 mg/m(2)/d) and 2-CdA (9 mg/m(2)/d) administered for 5d every 4 weeks; subsequent median follow-up was 2.8 years (range 0.03-6.4 years). Among the 7 patients who received at least two courses of therapy, disease activity decreased in 6 patients, and control of disease was achieved in all patients after a median delay of 5.5 months. All patients suffered World Health Organisation (WHO) grade 4 haematological toxicity. Two septic deaths occurred shortly after administration of the first course of 2-CdA/Ara-C; a third patient was withdrawn from the trial after the first course and subsequently died following haematopoietic stem cell transplantation. This series is small, but we conclude that 2-CdA and Ara-C combined chemotherapy probably has major activity in childhood refractory Langerhans cell histiocytosis.
  European Journal of Cancer 12/2005; 41(17):2682-9. · 5.54 Impact Factor
• Article: [Quality of life of adolescents surviving childhood acute lymphoblastic leukemia].

  G Vaudre, N Trocmé, J Landman-Parker, F Maout, M D Tabone, B Tourniaire, F Gouraud, C Dollfus, A Auvrignon, G Leverger
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  ABSTRACT: To evaluate how adolescents and young adults cured of acute lymphoblastic leukemia (ALL) treated during childhood have integrated the disease, and possible death related to cancer. Particularly, we have focused on experiences related to diagnosis announcement, hospitalisation and treatments and consequences on their social, psychological and somatic behaviour. Forty-one patients cured of ALL have been enrolled in the study and answered one interview with clinical psychologist or research nurse. Although 60% of the patients argued that they think rarely of their disease, 10% thought about it every day. Traumatic evidence was detectable in most of them. Physical pain was the most reported stress, mainly during hospitalisation (93%), as well as psychological suffering (83%). Afterwards, the mostly often-reported stress was psychological pain (61%). Sixty-six percent declared that they still experience psychological and health consequences at the time of the interview, in some cases reported as a handicap in their life. In 83% of the cases they considered themselves as cured, nevertheless fear of relapse persisted in 1/3. Ninety percent said they have a pleasant life, 56% did not like to talk about leukaemia and 70% thought they could have died. For 85%, disease has been the most important event of their life and 75% testify to repercussions of the disease on their family (family relationship changes, overprotection, siblings difficulties). Most of these patients declared to be 'as the others' and developed life projects, but overcoming the pain experience of the disease remained difficult. This study emphasized the need for long-term continuous information and reinforces the importance of addressing treatment psychological and physical pain mainly after the initial hospitalisation period.
  Archives de Pédiatrie 12/2005; 12(11):1591-9. · 0.30 Impact Factor
• Article: [Disseminated fusarium infection in two neutropenic children].

  A Petit, M D Tabone, D Moissenet, A Auvrignon, J Landman-Parker, L Boccon-Gibod, G Leverger
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  ABSTRACT: Disseminated fusariosis in children is a rare and serious fungal infection, that occurs especially in neutropenic immunosuppressed patients, treated for malignant hemopathy, or bone marrow transplant recipient. Treatment is difficult and mortality is estimated between 50 and 70% in adult patients. CASE REPORT 1: A ten-year-old boy, treated for an acute lymphoblastic leukemia in second relapse, presented a disseminated fusarium spp infection, that occurred during neutropenia. He died due to fusariosis infection in spite of amphotericin B treatment. CASE REPORT 2: A ten-year-old neutropenic girl, treated for an acute myeloïd leukemia, presented disseminated fusariosis, uncontrolled by amphotericin B. Recovery was observed after voriconazole introduction and resolution of neutropenia. Ten months later, she presented a leukemia's relapse, treated by new intensive chemotherapy with secondary prophylaxis by voriconazole, without fusariosis's recurrence. CONCLUSION: Voriconazole, a new triazole agent, seems to be an alternative antifungal agent to amphotericin B for disseminated fusarium infection, either at the acute phase or for secondary prophylaxis.
  Archives de Pédiatrie 08/2005; 12(7):1116-9. · 0.30 Impact Factor
• Article: NUP214-ABL1 amplification in t(5;14)/HOX11L2-positive ALL present with several forms and may have a prognostic significance.

  P Ballerini, M Busson, S Fasola, J van den Akker, H Lapillonne, S P Romana, P Marynen, O A Bernard, J Landman-Parker, R Berger
  Leukemia 04/2005; 19(3):468-70. · 9.56 Impact Factor
• Article: Vécu des adolescents guéris d'une leucémie aiguë lymphoblastique

  G. Vaudre, N. Trocmé, J. Landman-Parker, F. Maout, M. D. Tabone, B. Tourniaire, F. Gouraud, C. Dollfus, A. Auvrignon, G. Leverger
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  ABSTRACT: Purpose. – To evaluate how adolescents and young adults cured of acute lymphoblastic leukemia (ALL) treated during childhood have integrated the disease, and possible death related to cancer. Particularly, we have focused on experiences related to diagnosis announcement, hospitalisation and treatments and consequences on their social, psychological and somatic behaviour.Patients. – Forty-one patients cured of ALL have been enrolled in the study and answered one interview with clinical psychologist or research nurse.Results. – Although 60% of the patients argued that they think rarely of their disease, 10% thought about it every day. Traumatic evidence was detectable in most of them. Physical pain was the most reported stress, mainly during hospitalisation (93%), as well as psychological suffering (83%). Afterwards, the mostly often-reported stress was psychological pain (61%). Sixty-six percent declared that they still experience psychological and health consequences at the time of the interview, in some cases reported as a handicap in their life. In 83% of the cases they considered themselves as cured, nevertheless fear of relapse persisted in 1/3. Ninety percent said they have a pleasant life, 56% did not like to talk about leukaemia and 70% thought they could have died. For 85%, disease has been the most important event of their life and 75% testify to repercussions of the disease on their family (family relationship changes, overprotection, siblings difficulties).Conclusion. – Most of these patients declared to be 'as the others' and developed life projects, but overcoming the pain experience of the disease remained difficult. This study emphasized the need for long-term continuous information and reinforces the importance of addressing treatment psychological and physical pain mainly after the initial hospitalisation period.
  Archives De Pediatrie - ARCHIVES PEDIATRIE. 01/2005; 12(11):1591-1599.
• Article: A phase II trial of partially incompatible bone marrow transplantation for high‐risk acute lymphoblastic leukaemia in children: prevention of graft rejection with anti‐LFA‐1 and anti‐CD2 antibodies

  M. CAVAZZANA-CALVO, P. BORDIGONI, G. MICHEL, H. ESPEROU, G. SOUILLET, T. LEBLANC, J. L. STEPHAN, J. P. VANNIER, F. MECHINAUD, J. REIFFERS, [......], A. BARUCHEL, J. PICO, F. Bernaudin, C. Bergeron, E. PLOUVIER, C. THOMAS, J. WIJDENES, B. LACOUR, S. BLANCHE, A. FISCHER
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  ABSTRACT: Bone marrow transplantation (BMT) from matched sibling donors has been useful for the treatment of acute lymphoblastic leukaemia in children with a poor prognosis but is not available to more than two-thirds of patients who do not have a matched allogeneic donor. This study was undertaken to assess one strategy of marrow graft rejection prevention when alternative marrow sources such as HLA-phenoidentical unrelated volunteers and HLA-partially incompatible relatives were used. Results have been compared with two matched groups of children with the same risks factors and disease status who underwent HLA-genoidentical or autologous BMT. The conditioning regimen was the same for the three groups of patients; in the study group anti-LFA-1 and anti-CD2 monoclonal antibodies combined with T-cell depletion of the marrow was added to prevent graft rejection and graft-versus-host disease. Nineteen patients were included and followed for a median of 25 months (14 months to 3 years). Bone marrow engraftment occurred in 83% of the evaluable patients. Post-transplantation infectious diseases were the most frequent causes of death in the study group, occurring in 31% of patients. No fatal infections occurred in the two control groups. Post-transplantation relapse of leukaemia occurred in 26% of study group's patients, in 58% of autologous BMT control group's patients and in 5% of HLA-genoidentical allogeneic group's patients. The event-free survival was 83% in the HLA-genoidentical control group, and 30% and 24% in the study group and in the autologous control group, respectively. In conclusion, a high rate of engraftment was achieved by the use of anti-LFA-1 and anti-CD2 antibodies. Occurrence of a long-lasting immunodeficiency, however, led to a high incidence of lethal infections and relapses. Combined approaches are therefore to be investigated accelerating immune reconstitution after transplantations of T-depleted HLA partially incompatible marrow.
  British Journal of Haematology 10/2003; 93(1):131 - 138. · 4.94 Impact Factor
• Article: Lymphocyte-predominant Hodgkin's lymphoma in children: therapeutic abstention after initial lymph node resection--a Study of the French Society of Pediatric Oncology.

  B Pellegrino, M J Terrier-Lacombe, O Oberlin, T Leblanc, Y Perel, Y Bertrand, C Beard, C Edan, C Schmitt, D Plantaz, H Pacquement, J P Vannier, C Lambilliote, G Couillault, A Babin-Boilletot, I Thuret, F Demeocq, G Leverger, G Delsol, J Landman-Parker
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  ABSTRACT: To clarify treatment strategy for lymphocyte-predominant Hodgkin's lymphoma (LPHL), the French Society of Pediatric Oncology initiated a prospective, nonrandomized study in 1988. Patients received either standard treatment for Hodgkin's lymphoma or were not treated beyond initial adenectomy. From 1988 to 1998, 27 patients were available for study. Twenty-four patients were male, and median age was 10 years (range, 4 to 16 years). Twenty-two, two, and three patients had stage I, II, and III disease, respectively. Thirteen patients (stage I, n = 11; stage III, n = 2) received no further treatment after initial surgical adenectomy (SA). Fourteen patients received combined treatment (CT; n = 10), involved-field radiotherapy alone (n = 1), or chemotherapy alone (n = 3). The two groups were comparable for clinical status, treatment, and follow-up. Twenty-three of 27 patients achieved complete remission (CR). With a median follow-up time of 70 months (range, 32 to 214 months), overall survival to date is 100%, and overall event-free survival (EFS) is 69% +/- 10% (SA, 42% +/- 16%; CT, 90% +/- 8.6%; P <.04). If we considered only the patients in CR after initial surgery (n = 12), EFS was no longer significantly different between the two groups. Patients with residual mass after initial surgery (n = 15) had worse EFS if they did not receive complementary treatment (P <.05). Although based on a small number of patients, our study showed that (1). no further therapy is a valid therapeutic approach in LPHL patient in CR after initial lymph node resection, and (2). complementary treatment diminishes relapse frequency but has no impact on survival.
  Journal of Clinical Oncology 08/2003; 21(15):2948-52. · 18.37 Impact Factor