C Boccaccio

Publications (15)55.25 Total impact

• Article: Ex vivo expansion of megakaryocyte precursor cells in autologous stem cell transplantation for relapsed malignant lymphoma.

  D Decaudin, J-M Vantelon, J-H Bourhis, F Farace, M-L Bonnet, M Guillier, N Greissenger, M-C Marracho, S Assari, A-L Bennaceur, F Némati, J Michon, A G Turhan, C Boccaccio
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  ABSTRACT: To evaluate the impact of ex vivo expanded megakaryocyte (MK) progenitors on high-dose chemotherapy-induced thrombocytopenia, we conducted a phase II study in 10 patients with relapsed lymphoma. Two fractions of peripheral blood progenitor cells (PBPC) were cryopreserved, one with enough cells for at least 2 x 10(6) CD34+ cells/kg and a second obtained after CD34+ selection. Ten days before autologous stem cell transplantation, the CD34+ fraction was cultured with MGDF+SCF for 10 days. After BEAM (BCNU, cyclophosphamide, cytarabine, and melphalan) chemotherapy, patients were reinfused with standard PBPC and ex vivo expanded cells. No toxicity was observed after reinfusion. The mean fold expansion was 9.27 for nucleated cells, 2 for CD34+ cells, 676 for CD41+ cells, and 627 for CD61+ cells. The median date of platelet transfusion independence was day 8 (range: 7-12). All patients received at least one platelet transfusion. In conclusion, ex vivo expansion of MK progenitors was feasible and safe, but this procedure did not prevent BEAM-induced thrombocytopenia. Future studies will determine if expansion of higher numbers of CD34+ cells towards the MK-differentiation pathway will translate into a functional effect in terms of shortening of BEAM-induced thrombocytopenia.
  Bone Marrow Transplantation 01/2005; 34(12):1089-93. · 3.75 Impact Factor
• Article: Intensive chemotherapy with hematopoietic cell transplantation after ESHAP therapy for relapsed or refractory non-Hodgkin's lymphoma. Results of a single-centre study of 65 patients.

  C Soussain, B Souleau, J Gabarre, H Zouabi, L Sutton, C Boccaccio, N Albin, F Charlotte, H Merle-Béral, J Delort, J L Binet, V Leblond
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  ABSTRACT: This study was designed to assess the results of protracted courses of ESHAP (etoposide, cytarabine, cisplatin, methylprednisolone) therapy followed by intensive chemotherapy and hematopoietic cell transplantation (IC+HCT) for relapsed or refractory non-Hodgkin's lymphoma (NHL). Treatment consisted of 3 cycles of ESHAP; responsive patients (pts) then received 3 more cycles, and IC+HCT was used for pts in maintained partial (PR) or complete (CR) remission after the sixth ESHAP. Sixty-five pts entered the study. At enrollment, 27 pts had bone marrow (BM) and/or central nervous system (CNS) lymphomatous infiltration. Disease status was primary refractory lymphoma in 41 pts (63 %), and relapse in 24 pts (37 %). Results showed that two pts were not evaluable for the therapeutic response because of early treatment-related death. Thirty-nine (62 %) pts entered PR or CR after 3 cycles of ESHAP. Eleven pts subsequently had disease progression. Twenty-eight pts were in persistent CR or PR after 6 cycles of ESHAP. Refractory pts did not show a different response rate to relapsing pts (chi2= 1.73). Five pts were excluded from IC+HCT because of an inadequate graft or treatment-related toxicity. Twenty-three (35 %) pts completed the procedure. Five pts (22 %) relapsed after IC+HCT. The overall survival rate of the 39 responsive pts is 45 % at 60 months, with a median survival time of 30 months. Median survival among the 35 pts in whom second-line chemotherapy failed is 7.1 months, with a 4-year survival rate of 3 %. Despite the poor prognostic features of this group, 45% of pts responding to the first 3 cycles of chemotherapy are in prolonged remission, suggesting that rather than to transplant after just 2 cycles of salvage therapy, pursuing second-line chemotherapy may better discriminate between patients more likely to benefit from a subsequent transplant.
  Leukemia and Lymphoma 06/1999; 33(5-6):543-50. · 2.58 Impact Factor
• Article: A phase I/II dose-escalation study of herpes simplex virus type 1 thymidine kinase "suicide" gene therapy for metastatic melanoma. Study Group on Gene Therapy of Metastatic Melanoma.

  D Klatzmann, P Chérin, G Bensimon, O Boyer, A Coutellier, F Charlotte, C Boccaccio, J L Salzmann, S Herson
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  ABSTRACT: We performed a dose-escalating phase I/II study of retrovirus-mediated herpes simplex virus type 1 thymidine kinase (HSV-1-TK) suicide gene therapy for metastatic melanoma. HSV-1 TK expression, which specifically sensitizes transduced and bystander cancer cells to ganciclovir (GCV) toxicity, was mediated by one (four patients, first dose step) to three (four patients, second dose step) injections of "M11" retrovirus vector-producing cells in melanoma cutaneous nodules. After a 7-day period allowed for cancer cell transduction, GCV was administered for 14 days. Safety was assessed by clinical and laboratory evaluations, and efficacy was assessed by tumor measurements and histology. M11 doses ranged from 76 to 1247 x 10(6) cells. Treatment-related adverse events were mild and transient, limited to inflammatory skin reactions at injection and fever on repeated injections. Plasma GCV was in the active range (>0.2 microg/ml); transgene was detected by polymerase chain reaction in three of six patients; treated tumor size was moderately affected under GCV as compared with untreated tumors, although 2 weeks after GCV administration important (>50%) treated-tumor necrosis was evidenced on histology in three of eight patients. All patients showed disease progression on long-term follow-up. Thus, M11-mediated HSV-1 TK gene therapy was well tolerated over a wide dose range. The limited tumor response is likely to be related to poor gene transfer efficiency. However, necrosis following GCV administration in transduced tumors indicates a potential for treatment efficacy.
  Human Gene Therapy 12/1998; 9(17):2585-94. · 4.22 Impact Factor
• Article: Autologous hematopoietic stem cell transplantation as salvage treatment for advanced B cell chronic lymphocytic leukemia.

  L Sutton, K Maloum, H Gonzalez, H Zouabi, N Azar, C Boccaccio, F Charlotte, J M Cosset, J Gabarre, V Leblond, H Merle-Beral, J L Binet
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  ABSTRACT: Given the generally poor outcome of advanced B cell chronic lymphocytic leukemia, experimental approaches are warranted, especially for younger patients in whom classical treatments have failed. We therefore conducted a prospective single-center study, using polychemotherapy (ESHAP) to prepare patients for hematopoietic stem cell collection and autologous stem cell transplantation as consolidation therapy. Twenty patients entered the study. An adequate response to ESHAP was obtained in 13 patients, and sufficient stem cells for grafting were obtained in eight of the 12 patients who underwent the collection procedure. Six of these grafted patients are alive in complete clinical remission a median of 30 months after transplantation. It should be noted that we were only able to graft 40% of the patients enrolled in this study, either because a new remission could not be obtained or because not enough hematopoietic stem cells could be collected. This argues for stem cell collection as soon as a first remission is obtained, even if the autograft is done later in the course of the disease.
  Leukemia 12/1998; 12(11):1699-707. · 9.56 Impact Factor
• Article: The feasibility of peripheral blood stem cell collection for autograft following failure in bone marrow aspiration.

  F Lefrère, O Hermine, F Audat, A Buzyn, M Cavazzana-Calvo, C Boccaccio, B Varet
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  ABSTRACT: High doses of cytotoxic drugs may impair stem cell collection. Failure in stem cell collection by bone marrow aspiration can be rescued by harvesting Peripheral Blood Stem Cell (PBSC) after a combination of chemotherapy and hematopoietic growth factor. We, therefore, retrospectively evaluated the possibility of collecting PBSC after chemotherapy and/or G-CSF administration in 12 patients with insufficient Granulocyte-macrophage colony-forming unit (CFU-GM) counts after bone marrow aspiration (all patients had previously received heavy chemotherapy for hematologic malignancies); median collection of CFU-GM/kg count was 2,9 x 10(4)/kg (range 0,4 to 8 x 10(4)/kg) whereas the minimal count required for autografting is 10 x 10(4)/kg. Median collections of CFU-GM from PBSC were 5,8 x 10(4)/kg. While the CFU-GM collected in PBSC was higher than after bone marrow aspiration, only 5 patients had enough PBSC for autografting. In another case, addition of cells collected from both PBSC and bone marrow aspiration yielded a sufficient number of CFU-GM to allow autografting. Therefore in this selected and small group of patients, failure in bone marrow aspiration does not seem to be predictive of a low PBSC collection but a long therapy free interval and use of G-CSF alone for PBSC mobilization could constitute a valuable alternative. Three patients had a successful short term hematologic reconstitution out of the four patients having had an autograft.
  Hematology and Cell Therapy 07/1998; 40(3):133-7.
• Article: Autologous bone marrow transplantation in relapsed HIV-related non-Hodgkin's lymphoma.

  J Gabarre, V Leblond, L Sutton, N Azar, M Jouan, C Boccaccio, H Gonzalez, F Charlotte, M Gentilini, J L Binet
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  ABSTRACT: There are few reports of salvage chemotherapy for HIV-related non-Hodgkin's lymphoma (NHL). We report a relapsed HIV-related high-grade NHL which was treated successfully with ESHAP chemotherapy followed by high-dose chemotherapy and autologous bone marrow transplantation (ABMT). ABMT may later have triggered opportunistic infections in this patient.
  Bone Marrow Transplantation 01/1997; 18(6):1195-7. · 3.75 Impact Factor
• Article: [Difference in costs of autologous transplantation of peripheral and bone marrow hematopoietic stem cells. A retrospective analysis over 1 year of transplantation in lymphoma, Hodgkin's disease and myeloma in a Center].

  B Rio, Z Marjanovic, R Belhocine, A Vekhoff, V Andrieu, J Klaren, C Boccaccio, A Delmer, F Ajchenbaum-Cymbalista, M Hunault, A Bazarbachi, V Lévy, G Andreu, R Zittoun
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  ABSTRACT: The study analysed the financial benefits of transplantation with peripheral blood stem-cells primed after chemotherapy and growth factor in comparison with bone marrow transplantation. Twenty-three consecutive transplantations were performed during one year: 14 peripheral blood stem-cell (CSC group) and 9 bone marrow transplantations (MO group). No differences in patients characteristics were seen between the two groups except for higher number of "BEAM" conditioning in CSC group. Were analyzed delay in neutrophil and platelet recovery, numbers of days in hospital, with fever, under antibiotics, costs of supportive therapy, stem-cell collection and cryopreservation. Difference was significant for duration of neutropenia with advantages in CSC group, but the number on days in hospital, with fever or under antibiotics were similar. Number of platelet transfusions was reduced in CFC group: this economical advantage was lost with the cost of growth factor used for priming stem-cells stem-cell collections and cryopreservations. In our retrospective study, financial advantages associated to peripheral blood stem-cell transplantation was not verified.
  Annales de medecine interne 02/1996; 147(5):313-9.
• Article: Detection of malignant B cells in peripheral blood stem cell collections after chemotherapy in patients with multiple myeloma.

  F Dreyfus, V Ribrag, V Leblond, P Ravaud, J Melle, M C Quarre, C Pillier, C Boccaccio, B Varet
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  ABSTRACT: Autologous transplantation after high-dose chemo or radiotherapy is now frequently used for the treatment of patients with multiple myeloma (MM). The collection of peripheral blood stem cells (PBSC) has a theoretical advantage over autologous bone marrow collection as the malignant plasmacytic contamination is believed to be lower. However, the extent of B cell contamination in PBSC has not been extensively investigated. Using an immunoglobulin heavy chain gene 'fingerprinting' technique at diagnosis and during apheresis after one cycle of chemotherapy we detected a monoclonal population in 44% of PBSC samples (9 positives in 22 studied). There was no correlation between contamination and sex, age, Durie and Salmon classification, C-reactive protein and albumin. A significant correlation was observed with beta 2 microglobulin serum level (P = 0.02). Twenty one patients were grafted and up to the present, with a mean follow-up of 12 months, 6 patients have relapsed including 4 patients with contaminating B cells. Our results suggest that PBSC contamination, defines a 'poor risk' group of patients, with poor prognosis. However, we could not exclude reinitiation of the disease by plasmacyte stem cells after grafting.
  Bone Marrow Transplantation 06/1995; 15(5):707-11. · 3.75 Impact Factor
• Article: Peripheral blood stem cell collection and autografting in high risk lymphomas.

  F Dreyfus, V Leblond, C Belanger, J Gabarre, L Sutton, C Boccaccio, M C Quarre, V Ribrag, A Goy
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  ABSTRACT: Peripheral blood stem cells (PBSC) were collected from 29 patients with high risk Hodgkin's disease (n = 3) or non-Hodgkin's lymphoma (n = 26) in partial remission or first sensitive relapse. Patients had either bone marrow involvement or hypoplastic bone marrow. The conditioning regimen prior PBSC collection included amsacrine and cytosine arabinoside (Ara-C) or Ara-C alone. PBSC collection was performed after leukocyte counts reached 1 x 10(9)/1. A good yield was obtained in 23 patients, whereas sufficient numbers of CFU-GM were not obtained in six cases. Twenty-one patients have been transplanted. All patients except one achieved bone marrow engraftment. Eight patients are in complete remission (mean duration 15 months). The estimated 2 years survival rate is 46.4% (CI 25-68%). This procedure would seems a good alternative in poor prognosis lymphomas.
  Bone Marrow Transplantation 12/1992; 10(5):409-13. · 3.75 Impact Factor
• Article: The role of UV radiation in the prevention of human leukocyte antigen alloimmunization.

  G Andreu, C Boccaccio, J Klaren, C Lecrubier, F Pirenne, I Garcia, M Baudard, L Devers, J J Fournel
  Transfusion Medicine Reviews 08/1992; 6(3):212-24. · 3.58 Impact Factor
• Article: The effect of ultraviolet B light on antigen-presenting cells: implications for transfusion-induced sensitization.

  G Andreu, J Y Perrot, F Pirenne, C Boccaccio
  Seminars in Hematology 05/1992; 29(2):122-31. · 3.99 Impact Factor
• Article: Ultraviolet light-induced immunomodulation: a possible new tool in organ transplantation.

  G Andreu, C Boccaccio, J P Leguen, M Oleggini
  Annales de medecine interne 02/1992; 143 Suppl 1:52-6.
• Article: Ultraviolet irradiation of platelet concentrates: feasibility in transfusion practice.

  G Andreu, C Boccaccio, C Lecrubier, J Fretault, J Coursaget, J P LeGuen, M Oleggini, J J Fournel, M Samama
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  ABSTRACT: Ultraviolet (UV)-B irradiation abolishes lymphocyte functions (the ability to respond and to stimulate) in mixed lymphocyte culture (MLC). This effect may have practical application in the prevention or reduction of transfusion-induced alloimmunization against HLA class I antigens. To study this, platelet concentrates (PCs) were obtained with a cell separator, suspended in autologous plasma in a final volume of 400 mL, and transferred into a large (22 X 30 cm) cell culture bag. This plastic showed a good transmittance of UV-B rays at 310 nm (54%). PCs were placed between two quartz plates (surface of irradiation = 25 X 37 cm), and the two sides were irradiated simultaneously. Energy delivered to the surface of the plastic bag was automatically monitored. The ability to respond (in MLC and to phytohemagglutinin) and to stimulate allogeneic lymphocytes was completely abolished with energy of 0.75 J per cm2 (irradiation time less than 3 min). The temperature increase during irradiation was negligible. Platelet aggregation (collagen, adrenalin, ADP, arachidonic acid, ristocetin) was not impaired if UV-B energy was below 3 J per cm2. Recovery and survival of autologous 111In-labeled platelets were studied in four volunteers; no differences were found between UV-B-treated (1.5 J/cm2) platelets and untreated platelets. These results show that a large-scale clinical trial using UV-B-irradiated PCs to prevent HLA alloimmunization is feasible.
  Transfusion 07/1990; 30(5):401-6. · 3.22 Impact Factor
• Article: Ultraviolet irradiation of platelet concentrates: feasibility in transfusion practice

  G. Andreu MD Praticien Hospitalier, C. Boccaccio, C. Lecrubier, J. Fretault, J. Coursaget, J.P. LeGuen, M. Oleggini, J.J. Fournel, M. Samama, G. Andreu
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  ABSTRACT: Ultraviolet (UV)-B irradiation abolishes lymphocyte functions (the ability to respond and to stimulate) in mixed lymphocyte culture (MLC). This effect may have practical application in the prevention or reduction of transfusion-induced alloimmunization against HLA class I antigens. To study this, platelet concentrates (PCs) were obtained with a cell separator, suspended in autologous plasma in a final volume of 400 mL, and transferred into a large (22 times 30 cm) cell culture bag. This plastic showed a good transmittance of UV-B rays at 310 nm (54%). PCs were placed between two quartz plates (surface of irradiation = 25 times 37 cm), and the two sides were irradiated simultaneously. Energy delivered to the surface of the plastic bag was automatically monitored. The ability to respond (in MLC and to phytohemagglutinin) and to stimulate allogeneic lymphocytes was completely abolished with energy of 0.75 J per cm2 (irradiation time less than 3 min). The temperature increase during irradiation was negligible. Platelet aggregation (collagen, adrenalin, ADP, arachidonic acid, ristocetin) was not impaired if UV-B energy was below 3 J per cm2. Recovery and survival of autologous 111in-labeled platelets were studied in four volunteers; no differences were found between UV-B-treated (1.5 J/cm2) platelets and untreated platelets. These results show that a large-scale clinical trial using UV-B-irradiated PCs to prevent HLA alloimmunization is feasible.
  Transfusion 05/1990; 30(5):401 - 406. · 3.22 Impact Factor
• Source

  Available from: Georges Andreu

  Article: Prevention of HLA immunization with leukocyte-poor packed red cells and platelet concentrates obtained by filtration.

  G Andreu, J Dewailly, C Leberre, M C Quarre, M L Bidet, R Tardivel, L Devers, Y Lam, E Soreau, C Boccaccio
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  ABSTRACT: HLA immunization is a common complication of transfusion therapy in 30% to 60% of oncohematologic patients. Evidence shows that leukocytes present in cellular blood products are the main component involved in the occurrence of HLA immunization, and several studies showed that leukocyte-poor blood products are less able to induce it. However, leukocyte-poor platelet concentrates obtained by conventional techniques, ie, centrifugation, frequently have a high level of remaining leukocytes. Cotton wool filter Imugard IG 500 can be used to obtain leukocyte-poor cellular blood products. The technique is easy to perform, even in an emergency, and can be used with either packed RBCs or platelet concentrates. Means of 97%, 92%, and 76% elimination of leukocytes are obtained for packed RBCs, pooled standard platelet concentrates, and single-donor platelet concentrates, respectively. Patients were randomized to receive either standard (control group) or filtered (leukocyte-poor group) blood products. Of 112 randomized patients, 69 were evaluable, 35 in the control group and 34 in the leukocyte-poor group. Both groups are comparable according to age, diagnosis, sex ratio, previous transfusions, and pregnancies. There is a significant difference in regard to the HLA immunization rate (31.4% in the control v 11.7% in the leukocyte-poor group, P less than .05) and frequency of refractoriness to platelet transfusions (46.6% v 11.7%, P less than .05). We conclude that this filtration technique can be an efficient means to reduce the HLA immunization rate in polytransfused oncohematologic patients.
  Blood 10/1988; 72(3):964-9. · 9.90 Impact Factor