BJH - volume 6, issue Abstract Book BHS, january 2015
M. Berehab , R. Rouas , D. Douaa , D. Bron MD, PhD, P. Lewalle MD, PhD, P. Martiat MD, PhD, M. Merimi
BJH - volume 5, issue Abstract Book BHS, january 2014
R. Rouas , M. Merimi , M. Berehab , D. Moussa-Agha , P. Lewalle MD, PhD, P. Martiat MD, PhD
BJH - volume 4, issue 4, december 2013
P. Lewalle MD, PhD, R. Rouas , D. Bron MD, PhD, P. Martiat MD, PhD
In 1999, we decided to start a phase I/II study of haploidentical transplantation for high-risk patients. The aim of the work was to implement a strategy to accelerate and strengthen the immune reconstitution by using nonspecific manipulation post-transplant and by developing specific strategies directed against viral antigens. The goal was to increase the graft-versus-leukemia effect without inducing or aggravating the deleterious graft-versus-host disease. The conditioning regimen, adapted to our group of patients, remained the same throughout. Importantly, the first recruited patients were in refractory disease, over time we were referred less advanced patients (complete remission 2 or more). There were 45 patients, all at high-risk, among which 27 were in refractory relapse. We questioned the importance of post-transplant growth factors policy and the influence of donor lymphocyte infusion. Because of the conditioning, transplant-related mortality was low at 3 months, but thereafter changed unfavourably when using granulocyte macrophage-colony stimulating factors in an increased incidence of acute graft-versus-host disease. As a whole the long-term survival of the patients was poor (18%) but improved a lot when transplanted patients were in complete remission (leukaemia-free survival of 39% at five years). Regarding the use of growth factors and donor lymphocyte infusion, granulocyte macrophage-colony stimulating factors with donor lymphocyte infusion induced a very high transplant-related mortality due to a high rate of severe graft-versus-host disease, while the combination of granulocyte colony-stimulating factors and a moderate dose of donor lymphocyte infusion was much safer but didn’t overcome the high relapse rate in refractory patients. The combination of granulocyte colony-stimulating factors and donor lymphocyte infusion might nonetheless be sufficient to decrease the infection rate in patients transplanted in complete remission. The use of granulocyte macrophage-colony stimulating factors leads to an unacceptable lethal graft-versus-host disease rate. The 39% at five years leukaemia-free survival in patients in complete remission compares favourably with what can be achieved with matched unrelated donors in complete remission 2 or more.
(BELG J HEMATOL 2013;4(4): 151–160)
Read moreBJH - 2013, issue BHS Abstractbook, january 2013
R. Rouas , M. Berehab , N. Naamane , P. Lewalle MD, PhD, D. Moussa-Agha , M. Merimi , P. Martiat MD, PhD
BJH - 2013, issue BHS Abstractbook, january 2013
H. Fayyad Kazan , R. Rouas , P. Lewalle MD, PhD, F. Jebbawi , M. Merimi , A. Burny , B. Badran , P. Martiat MD, PhD
BJH - 2013, issue BHS Abstractbook, january 2013
R. Rouas , F. Jebbawi , H. Fayyad Kazan , M. Merimi , P. Lewalle MD, PhD, B. Badran , P. Martiat MD, PhD
BJH - volume 3, issue 2, june 2012
P. Martiat MD, PhD, A. Bosly MD, PhD, L. Noens MD, PhD, G. Verhoef MD, PhD, B. Houssa , P. Lacante MD
This study aimed to collect information on daily clinical use of dasatinib (Sprycel®) in Belgium, when used for treating patients with chronic myeloid leukaemia (CML) and Philadelphia chromosome positive acute lymphoblastic leukaemia (Ph+ ALL) with resistance or intolerance to prior therapies including imatinib.
We used an observational retrospective approach to collect data from 84 patients (72 CML and 12 Ph+ ALL) from 23 Belgian centres who received dasatinib in the period between October 1, 2007 and October 31, 2009.
The majority of patients had been diagnosed with chronic phase CML (69%). All patients had received prior treatment with imatinib before initiation of dasatinib. Main reasons for switching to dasatinib were development of resistance (65%) or intolerance (31%). In 89% of chronic and accelerated phase CML patients, dasatinib therapy induced complete haematological response (CHR). Major cytogenetic response (MCyR) was observed in 63% and 67% of chronic and accelerated phase patients, respectively.
This study population is representative for patients receiving dasatinib treatment in Belgium. Dasatinib was well tolerated and patient outcome confirmed dasatinib use has significant clinical value in the treatment of CML and Ph+ ALL patients with resistance or intolerance to prior imatinib therapy.
(BELG J HEMATOL 2012;3:51–58)
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