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Biomedical subjects

M F Avril

Publications and source records attributed to M F Avril.

At least 73 records · Page 4Linked to original sources
PubMed1995

Comparison between familial and nonfamilial melanoma in France.

BACKGROUND AND DESIGN: Five percent to 10% of cutaneous malignant melanomas (CMMs) occur in a familial setting. Clinical, epidemiologic, and genetic studies of familial CMM in different regions of the world have led to various results. To assess the characteristics of familial CMM in France, the clinical, histologic, and epidemiologic characteristics of 295 patients with CMM were recorded, and a comprehensive familial investigation was performed for each case. Patients with a family history of CMM were compared with nonfamilial cases. RESULTS: Cutaneous malignant melanoma occurred as a familial cancer in 22 (8%) of 295 patients. Among the multiple variables studied, those significantly associated with the familial occurrence of CMM were red hair, inability to tan, and presence of clinically atypical moles. When these variables were considered together in a multivariate analysis, only the association with red hair (P = .001) and atypical moles (P < .05) remained significant. In addition, the patients with familial melanoma exhibited the following tendencies: a younger age at diagnosis, a higher number of moles, and the development of multiple primary melanomas, but these results did not reach statistical significance. Factors relating to UV light exposure, histologic features of CMM, course of the disease, and occurrence of nonmelanoma cancers showed a similar distribution between familial and nonfamilial cases. CONCLUSION: A familial investigation should be performed for each patient with CMM in France, particularly when he or she exhibits phenotypic risk factors for CMM such as red hair and atypical moles.

Adult↗
PubMed1995

Lack of evidence of HTLV-I/II infection in T CD8 malignant or reactive lymphoproliferative disorders in France: a serological and/or molecular study of 169 cases.

Human T lymphotropic virus type II (HTLV-II), originally isolated in 1982 from a patient with a "T hairy cell leukemia", has not yet been proven to be the causative agent of any specific hematological disease. In order to screen for such an event, and because HTLV-II has a preferential tropism for OKT8 (CD8) T cells (both in vivo and in vitro), we searched for the presence of HTLV-II in lymphoproliferative diseases (LP) of CD8+ T cells. We report a serological and/or molecular study of 169 patients with a T CD8 LP, including 76 patients with malignant or reactive T CD8 LP (34 lymphomas, 27 large granular leukemias, three prolymphocytic leukemias, one hairy cell leukemia, 11 reactive T CD8 LP) and 93 HIV-1+ patients with a T CD8 peripheral lymphocytosis ( > 1500/mm3) from a prospective HIV cohort involving 1264 individuals. In the first series, the 40 sera available were all HTLV-I/II negative, except a 67-year-old French Guyanan man, with a cutaneous large T CD8 cell lymphoma, HTLV-I+. Furthermore, the molecular analysis of the 69 available DNA samples by PCR failed to detect any proviral HTLV-I/II sequences, except for the HTLV-I+ patient. The serological study of the 93 HIV-1+ individuals with CD8 lymphocytosis, showed that three patients were HTLV-I+, but none was HTLV-II+. Thus, in contrast to HTLV-I, whose etiological role in adult T cell leukemia is now well established, there is neither epidemiological nor molecular evidence that prototypic HTLV-II may be etiologically associated specifically with any of the CD8+ T cell LP investigated in this report.

Base Sequence↗
PubMed1994

Coexistent cutaneous T-cell lymphoma and B-cell malignancy. French Study Group on Cutaneous Lymphomas.

BACKGROUND: The coexistence of cutaneous T-cell lymphoma (CTCL) and a B-cell malignancy (BCM) is rare. OBJECTIVE: Our aim was to assess the clinical and pathologic aspects of coexistent CTCL and BCM and to examine potential explanations for this association. METHODS: We report six cases of concurrent CTCL and BCM in which B- and T-cell lineages were demonstrated by immunologic studies. The literature includes 13 additional cases. All 19 CTCL-BCM cases are reviewed. RESULTS: CTCL either preceded or followed the BCM, which was a low-grade malignancy in most cases (16 of 19). Possible explanations for the association include a genetic predisposition, underlying viral infection, chemotherapy-induced carcinogenesis, stimulation of a B-cell clone by malignant helper T cells, and alterations in progenitor cells before determination of B- and T-cell lineage. CONCLUSION: An alteration in progenitor cells, with subsequent oncogenic activation of variable origin, might account for most cases of coexistent CTCL and BCM.

Adult↗
PubMed1994

[Late recurrence of melanoma beyond 10 years].

Late recurrence phenomenon in the course of melanoma (i.e. first recurrence after a 10 years or more disease free interval) is often ignored. Eleven cases and a literature review are presented. Main conclusions are: --lack of clinical or pathological criteria predicting the risk for a given patient, --possible underevaluation of the number of patients affected by these late recurrences, due to a premature follow up cessation, --advantages of prolonged clinical follow up over ten years aimed at early diagnosis of locoregional metastasis which may benefit from successful surgical treatment.

Adult↗
PubMed1994

[Cutaneous metastasis disclosing adrenal cortical carcinoma].

Metastases to the skin from internal malignant neoplasms are uncommon and often preterminal event. Cutaneous metastases from an adrenal cortical carcinoma have rarely been reported even in the advanced stages of the disease. A patient was initially seen with a small cutaneous lesion on the cheek and was found to have a large adrenal cortical tumor. Histologic comparison proved that the cutaneous lesion was a metastase from an adrenal cortical carcinoma.

Adrenal Cortex Neoplasms↗
PubMed1993

[The cost of cytokines].

The use of cytokines (interferons, interleukin-2, growth factors) is in full development, but the new drugs issued from biotechnology are costly. In order to control consumption, these products are made available only to hospital pharmacists, and they are paid by the prescribing establishments from global funds. This results in an ever growing financial burden on the hospital pharmaceutical budget. Physicians will have to conciliate 2 objectives: make the patients benefit from the new drugs, and control the expenses by using these drugs only when necessary.

Cytokines↗
PubMed1993

Cutaneous side effects associated with interleukin 2 administration for metastatic melanoma.

BACKGROUND: Cutaneous changes associated with recombinant interleukin 2 (r IL-2) administration are frequent but have been rarely studied in a large series. OBJECTIVE: We analyzed these clinical, microscopic, and immunologic changes. METHODS: Patients with metastatic melanoma treated with r IL-2 were studied. The eruption was scored as mild or severe. Biopsy specimens were obtained for histopathology, ultrastructural analysis, and immunophenotyping. Chi-square and t tests were used for statistics. RESULTS: Twenty-five patients were included. Eruptions were observed in 56 of 78 cycles (72%); 53 were mild with a burning pruriginous erythema, and 3 were severe with urticaria, necrotic lesions, and blisters. Regression was constant without sequelae. Pathologic changes were mild with a mononuclear cell infiltrate of activated helper T phenotype, expressing LFA-1. Keratinocytes and endothelial cells displayed intercellular adhesion molecule-1 and HLA-DR. Cells rarely expressed CD25. CONCLUSION: Administration of r IL-2 triggers non-treatment-limiting cutaneous inflammation.

Adult↗
PubMed1993

Analysis of T cell receptor variability in tumor-infiltrating lymphocytes from a human regressive melanoma. Evidence for in situ T cell clonal expansion.

Malignant melanomas are often infiltrated by T lymphocytes. It is postulated that the presence of tumor-infiltrating lymphocytes (TIL) reflects ongoing immune responses against transformed cells. Such "responses" appear generally inefficient with the potential exception of infrequent clinical situations characterized by spontaneous tumor regression. We have characterized here the molecular structure of the T cell receptor beta chain expressed by TILs in a case of regressive melanoma. Advantage was taken of the PCR technology to study T lymphocytes directly without cell culture. Experimentally validated V beta subfamily specific primers were used to evaluate the V beta usage in TILs and control samples. Our results reveal that clonal T cell populations, precisely defined by their V-D-J junctional sequences, are amplified at the tumor site. The existence of such local antigen-driven selections support the hypothesis that antitumor responses may indeed take place in regressive melanoma.

Aged↗
PubMed1993

[Extra-abdominal desmoid tumor. Diagnostic, prognostic and therapeutic aspects].

We report the case of a 19 year-old female patient who consulted for a recurrent desmoid tumor of the back which had initially developed during childhood. Its clinical aspect was reminiscent of a localized subcutaneous tumor, but surgical exploration revealed multiple ramified extensions spreading over a wide area deep into the underlying muscular tissue. In spite of two attempts at wide surgery, complete resection was not achieved. EAD tumors are a distinct category between fibromatosis and fibrosarcoma. There is a direct contrast between the benign histological structure and the lack of a metastatic potential, and the fact that they are highly aggressive locally with a great proportion of relapses occurring after resection. Prognosis, which is good in terms of survival, is determinant in the choice of treatment which must remain conservative in the majority of cases. Wide, non mutilating surgery offers the best chances of cure without sequelae. When surgery may be mutilating, 50-60 Gy of radiotherapy (RT) is a good alternative and affords a high rate of complete regression over a long period of time. The value of adjuvant RT after surgical resection has yet to be determined. Hormonotherapy and other drugs are currently being evaluated.

Adult↗
PubMed1993

Long-term effects on the thyroid of irradiation for skin angiomas in childhood.

Thyroid morphological and functional tests were carried out on 396 patients who were recalled because their thyroid gland had been exposed during hemangioma irradiation in childhood 11-43 years before (median, 22 years). The irradiations have been classified into two categories based on their duration: short duration, from a few seconds to a few minutes (90S and X rays), and long duration, from 30 min to several hours (336Ra, 192Ir, and 32P). The risk of a thyroid nodule increased significantly with the total dose received by the thyroid; it was linked to the dose delivered in the short duration (excess relative risk per Gy = 10), but not to that delivered in the long duration. The risk of a simple diffuse goiter, which also increased with the dose received by the thyroid, did not depend on the duration of the irradiation. In conclusion, this study emphasizes the role of the dose rate in the risk of thyroid nodule, the detection of which does not appear to be improved by plasma thyroid marker determination.

Child↗
PubMed1992

Analysis of T-cell receptor alpha/beta variability in lymphocytes infiltrating a melanoma metastasis.

Multiple experimental and clinical studies have suggested that the immune system may, to some extent, control the development of melanomas. The presence of tumor-infiltrating lymphocytes could reflect an in situ immune reaction directed to the malignant cells. The characterization of T-cell receptor (TCR) expressed by tumor-infiltrating lymphocytes is one way to precisely analyze these local T-cell responses. In this study, we have assessed the TCR alpha/beta variability in tumor-infiltrating lymphocytes from a subcutaneous metastasis of a melanoma patient. Using the anchored-polymerase chain reaction 268 TCR alpha and 266 TCR beta chain transcripts have been cloned and sequenced. Their analysis shows that the T-cell infiltrate is extremely diverse, with no preferential TCR gene segment usage.

Adult↗
PubMed1992

Regression of primary melanoma with metastases.

Seven cases of spontaneous and complete regression of primary melanoma with metastasis are reported. The ages of the patients ranged from 33 to 68 years. There were five men and two women. All patients had had a cutaneous pigmented lesion that underwent a two-stage course: enlargement and darkening, then flattening and depigmentation. Within a few months to 4 years after depigmentation, regional node(s) developed and were removed, confirming the diagnosis of melanoma. An histopathologic examination of the primary sites failed to show residual malignant cells and characteristic features. Primary melanomas that have completely regressed are easily overlooked.

Adult↗
PubMed1992

Oral contraceptive use and risk of cutaneous malignant melanoma in a case-control study of French women.

We report the results of a case-control study designed to analyze the relationship between oral contraceptive use (OC) and the risk of cutaneous malignant melonama (MM) in 240 White women under the age of 45. Five French centers participated in the study between February 1982 and January 1987 for periods of eight to 54 months, depending on the center. Cases were 91 consecutive newly diagnosed patients with histologically verified MM. Each case was matched with one or two controls on year of birth, date of interview, and treatment center. Controls were 149 patients with either malignant or nonmalignant disease who came to the center for diagnosis and treatment. Odds ratios (OR) were estimated by multivariate analyses taking into account age at menarche, sunlight exposure, and skin characteristics. No significant relation was found between the risk of MM and the total duration of OC use, age at start of use, and elapsed time since the first OC use. However, when the analysis was restricted to women aged 30-40 years, i.e., those who were able to use OC for 10 years or more, or who had started OC use 15 years or more before the diagnosis, the risk of MM increased significantly with the duration of OC use (P = 0.03). A total of more than 4,000 hours of sunlight exposure, and menarche before the age of 14 also were found to increase significantly the risk of MM (OR = 5.4, 95 percent confidence interval [CI] = 1.6-18.3; and OR = 3.6, CI = 1.0-12.5, respectively).

Adult↗