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Biomedical subjects

B Coiffier

Publications and source records attributed to B Coiffier.

At least 145 records · Page 8Linked to original sources
PubMed1995

Mucosa-associated lymphoid tissue lymphomas.

Mucosa-associated lymphoid tissue (MALT) lymphomas are a distinct subgroup of non-Hodgkin's lymphoma with a particular clinicopathologic behavior. The gastrointestinal tract is involved in two thirds of the cases, but it may be observed in lung, breast, bladder, conjunctiva, kidney, liver, skin, salivary glands, thyroid, and thymus. This type of lymphoma tends to appear in patients with a history of autoimmune disease or chronic inflammatory disorders. In the stomach, this lesion is induced by Helicobacter pylori and is characterized by an accumulation of lymphoid tissue leading to chronic gastritis. The preceding lymphoid disorder is represented by Sjögren's syndrome, Hashimoto thyroiditis, and interstitial lymphoid pneumonia in the thyroid, salivary glands, or lung, respectively. Lymphoma cells initially arise from the marginal zone localized around reactive follicles and secondarily invade epithelial tissue to form the characteristic lymphoepithelial lesion. Patients with gastrointestinal MALT lymphoma generally present with localized disease without any adverse prognostic factors. These patients have long survival rates. Recurrences may appear in the same organ or in other extranodal sites. Nongastrointestinal MALT lymphoma patients seem to have a similar outcome. Patients may be treated with surgery or radiotherapy if the disease is localized, or with single-agent chemotherapy if it is disseminated. Reversion of the chronic inflammatory disorder with antibiotics, such as for gastric involvement, is a new observation that may change therapeutic options in the future.

Breast Neoplasms↗
PubMed1994

Nonfollicular small B-cell lymphomas: a heterogeneous group of patients with distinct clinical features and outcome.

Two hundred sixteen patients with a nonfollicular small cell lymphoma followed up in our department over a 5-year period have been reviewed to define the clinical behavior and survival of patients with each histologic subtype. The respective frequencies of major subtypes were: small lymphocytic/lymphoplasmacytoid lymphoma (immunocytoma, SL/LPL), 28%; large cell-rich immunocytoma (LCRI), 7%; mantle cell lymphoma (MCL), 24%; mucosa-associated lymphoid tissue-lymphoma (MALT-L), 20%; other rare subtypes, 6%; and nonclassified or nonreviewed, 14%. The SL/LPL patients and the MALT-L patients had a relatively indolent disease, usually disseminated for SL/LPL and usually localized for MALT-L. Both subtypes have a long time to treatment failure (TTF; median, 48 and 58 months, respectively) and long survival (median, 118 and 98 months, respectively). The LCRI patients or the MCL patients had more aggressive clinical or biologic features and experienced shorter TTF (median, 26 and 14 months, respectively) and shorter survival (median, 55 and 52 months, respectively). None of these histologic subtypes was associated with a significant cure rate. MALT-L patients did relapse regardless of the initial localization or treatment and at a similar rate to the SL/LPL patients. Factors associated with a worse outcome in nonfollicular small cell lymphoma patients are identical to those described in other lymphoma subtypes: advanced clinical stage, poor performance status, high tumor bulk, and high lactic dehydrogenase or beta 2microglobulin levels. For patients with disseminated disease, standard chemotherapy regimens did not allow a long TTF; therefore, new therapeutic strategies must be developed.

Adult↗
PubMed1994

Interleukin-2 treatment in lymphoma: a phase II multicenter study.

A phase II study was undertaken to assess whether continuous infusion of high-dose recombinant interleukin-2 (rIL-2) alone was active against different histologic subtypes of heavily pretreated lymphoma. Sixty one lymphomas were included in the study. rIL-2 (Roussel UCLAF, Romainville, France) was administered by continuous infusion at 20 x 10(6) IU/m2 for three cycles of 5 days, 4 days, and 3 days, during the first week, third week, and fifth week, respectively. Twenty-four low-grade non-Hodgkin's lymphomas (NHL) were resistant to an anthracycline-containing regimen. Twenty-three intermediate and high-grade NHL were refractory to initial treatment or to salvage therapy. Seven Hodgkin's diseases were refractory to at least three regimens or relapsed after autologous bone marrow transplantation. Seven mycosis fungoides were refractory to chemotherapy. In low-grade NHL, one complete response (CR) was observed. In aggressive NHL, there were three CRs and two partial responses (PRs). No response was noted in Hodgkin's disease. One CR and four PRs were observed in mycosis fungoïdes. Complete response durations were 23, 20, 17, 12, and 4 months. Grade 4 toxicity was observed in 29 patients leading to arrest of therapy in 12 patients. The response to rIL-2 therapy in lymphoma differs according to histologic subtypes. Five responses were observed in 23 aggressive lymphomas. Five of seven mycosis fungoïdes responded; these preliminary results warrant testing of a larger number of patients.

Adult↗
PubMed1994

Detection of the chromosomal translocation t(11;14) by polymerase chain reaction in mantle cell lymphomas.

The t(11;14)(q13;q32) and its molecular counterpart, BCL1 rearrangement, are consistent features of mantle cell lymphoma (MCL). Rearrangement is thought to deregulate the nearby CCND1 (BCL1/PRAD1) proto-oncogene, a member of the cyclin G1 gene family, and thereby to contribute to tumorigenesis. We and others have previously shown that the BCL1 locus is rearranged in 55% to 60% of MCL patients and that, on chromosome 11, more than 80% of the breakpoints are localized within a 1-kbp DNA segment known as the major translocation cluster (MTC). We have determined the nucleotide sequence for a portion of the MTC region, and constructed chromosome 11-specific oligonucleotides that were in conjunction with a consensus immunoglobulin (Ig) heavy chain joining region (JH) primer used to perform the polymerase chain reaction (PCR) to amplify t(11;14) chromosomal junctional sequences in DNA from 16 MCL patients with breakpoints in the MTC region. 15 of the 16 breakpoints that occurred at the MTC region were amenable to PCR detection. The sizes of the amplified bands, the existence or not of a Sac I site in the PCR products, and nucleotide sequencing of the amplified DNA from four patients showed that the breakpoints share a remarkable tendency to tightly cluster within 300 bp on chromosome 11, some of them occurring at the same nucleotide. On chromosome 14, the breakpoints were localized within the Ig JH. Our findings indicate that a BCL1 rearrangement can be detected using this approach in roughly one half of the MCL patients. This has implications for both the diagnosis and the clinical management of MCL.

Base Sequence↗
PubMed1994

Heterogeneity of neoplastic and reactive cell proliferation in non-Hodgkin's lymphomas linked to patient survival.

This study was undertaken to determine the characteristics of the proliferation of malignant and reactive cells in non-Hodgkin's lymphoma (NHL). Cell kinetics were studied in 76 previously untreated cases of NHL by flow cytometry after a double labeling of membrane antigen and DNA. Results were analyzed according to clinical and biologic characteristics of the patients. In B-cell NHL, percentages of B and T cells in S-phase were strongly linked (r = .82). The level of proliferation of malignant B cells and reactive T cells was significantly higher in aggressive lymphomas, compared with low grade, diffuse small cleaved cell NHL or reactive lymph nodes (P < .001). The percentages of malignant B cells in S-phase were lower when reactive T cells were more numerous (n = 59, r = -.264, P < .05), particularly in high-grade NHL (n = 16, r = -.78, P < .001). In the whole population of patients, survival was longer when the percentage of cells in S-phase (n1 = 38, n2 = 33) or S+G2 + mitosis (M) (n1 = 36, n2 = 35) was less than 3.2% and 7.25%, respectively (P < .005). When considering only B-cell NHL, survival was longer when the percentage of B cells in S-phase was less than 4.5% (n1 = 31, n2 = 28, P < .04). Among the slowly proliferative groups of lymphomas, this prognostic value was retained when S-phase value was less than 1% (n1 = 16, n2 = 13, P < .002). Furthermore, prognosis was better when the percentage of T cells in S-phase was less than 2.75% (n1 = 30, n2 = 29, P < .01) or when reactive CD4-positive T cells were more than 14.5% (n1 = 24, n2 = 24, P < .04). This result remained true in the group of highly proliferative lymphomas. These results illustrate the complexity of the interactions between malignant and reactive cells in NHL, with possible opposite effects on tumor cell growth.

Adolescent↗
PubMed1994

Report on a workshop convened to discuss the pathological and staging classifications of gastrointestinal tract lymphoma.

It was considered timely to review the pathological and staging classifications of GI tract lymphoma. This meeting specifically did not address the question of treatment; the management of GI tract lymphoma could perhaps form the basis for a further workshop. The following recommendations were made: to adopt the Isaacson histological classification, that all patients with GI tract lymphoma be investigated uniformly, to record the prognostic factors described above, to use the staging classification shown above. It is hoped that these recommendations will be taken into account in the design of future clinical trials of therapy for GI tract lymphoma.

Gastrointestinal Neoplasms↗
PubMed1994

Heterogeneity of acute lymphoblastic leukemia in HIV-seropositive patients.

BACKGROUND: As opposed to large-cell or Burkitt's-type non-Hodgkin's lymphoma, acute lymphoblastic leukemia (ALL) is rarely observed in HIV-seropositive patients and is not a criteria of AIDS in the 1986 classification established by the C.D.C. Furthermore, the few cases of ALL reported so far were B-cell ALL, Burkitt's-type. DESIGN: We recently observed, with unexpected frequency, ALL cases in this setting: over a 5-year period, 5 of 25 HIV-positive patients referred to our center for hematological malignancies, had ALL. Three patients, who had previously been asymptomatic with regard to HIV infection, had typical Burkitt's-type ALL. Complete remission was achieved in all cases with high-dose lymphoma-type chemotherapy regimens, but 2 patients relapsed 3 and 27 months after diagnosis. Their clinical characteristics and outcome are discussed with reference to the cases reported thus far in the literature. One patient had common early pre-B ALL with the Philadelphia chromosome, and one had a T-cell ALL with an unusual CD7+, CD4-, CD8- phenotype. Prognosis was very poor in both cases. CONCLUSION: The exact incidence and the therapeutic management of B-cell ALL in HIV-positive patients warrants further evaluation. In addition, we show that there may be a heterogeneity among ALL cases in this setting, with the first description of 2 non-Burkitt's ALL with atypical features in HIV-positive patients.

Adult↗
PubMed1994

Comparison of autologous bone marrow transplantation with sequential chemotherapy for intermediate-grade and high-grade non-Hodgkin's lymphoma in first complete remission: a study of 464 patients. Groupe d'Etude des Lymphomes de l'Adulte.

PURPOSE: Intensive chemotherapy followed by autotransplantation has given promising results in partially responding or sensitive relapsed patients with aggressive non-Hodgkin's lymphoma. In 1987, we designed a randomized study to evaluate the potential benefit of a high-dose regimen containing cyclophosphamide, carmustine, and etoposide (CBV) followed by autotransplantation over a consolidative sequential chemotherapy (ifosfamide, etoposide, asparaginase, and cytarabine) in patients in first complete remission with intermediate- and high-grade non-Hodgkin's lymphoma. PATIENTS AND METHODS: Patients were younger than 55 years and had at least one adverse prognostic factor. Induction treatment was that of the LNH84 protocol with an open randomization on the anthracycline. Patients in complete remission were further randomly assigned to receive either consolidation procedure. RESULTS: After induction treatment, 464 patients were assessable for the consolidation phase. With a median follow-up duration of 28 months, the 3-year disease-free survival rate was 52% (95% confidence interval, 45% to 59%) in the sequential chemotherapy arm and 59% (95% confidence interval, 52% to 66%) in the autologous transplant arm (P = .46, relative risk = 0.90). The 3-year survival rate did not differ between sequential chemotherapy and autotransplantation, at 71% (95% confidence interval, 64% to 78%) and 69% (95% confidence interval, 62% to 76%), respectively (P = .60, relative risk = 1.11). CONCLUSION: For such a subset of patients, consolidation with the CBV regimen followed by autologous bone marrow transplantation is not superior to sequential chemotherapy.

Adolescent↗
PubMed1994

Treatment with very low-dose GM-CSF in myelodysplastic syndromes with neutropenia. A report on 28 cases.

We treated 28 cases of myelodysplastic syndrome (MDS) with neutropenia by very low-dose GM-CSF (0.25 or 0.5 micrograms/kg/day). Median age was 69 years. Nine patients had RA, 18 had RAEB, and one had RARS. Eighteen patients had absolute neutrophil counts (ANC) < or = 0.5 x 10(9)/l, and ten had ANC between 0.5 and 1.0 x 10(9)/l. Ten patients had experienced > or = WHO grade II infection(s) during the preceding 3 months. Eighteen patients (64%) had a response (i.e. ANC at least doubled and > or = 1 x 10(9)/l after 1 month), including 4/8 patients treated at 0.25 mu/kg/day, and 14/20 treated at 0.5 microgram/kg/day (difference not significant). Two of the non-responders obtained a response after dose escalation to 0.5 and 1 microgram/kg/day, respectively. The only prognostic factor of response was FAB subtype (10/11 responses in patients with RA or RARS, vs. 8/17 in RAEB, p = 0.04). Patients with ANC < or = 0.5 x 10(9)/l had a 55% (10/18) response rate, which was not significantly lower than the 80% (8/10) response rate observed in patients with ANC > 0.5 x 10(9)/l. Side-effects were generally moderate, except in three patients where the drug had to be discontinued, including the only patient who progressed to AML. In responders, GM-CSF was continued during 2 to 14 months (median 6), and the response persisted in all but one case, who relapsed after 60 days of treatment. During follow-up, only one responder had > or = WHO grade II infections, as compared to five of the non-responders (of whom two had fatal infectious episodes). In conclusion, very low-dose GM-CSF can durably increase ANC in about two thirds of MDS with neutropenia. Although it remains to be shown in randomized trials that it can reduce the incidence of infections and improve survival in MDS, very low-dose GM-CSF may be an interesting approach in MDS, associated to reasonable cost.

Aged↗