References of "Beguin, Yves"
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See detailRationale for the potential use of mesenchymal stromal cells in liver transplantation
Vandermeulen, M.; DE ROOVER, Arnaud ULg; BRIQUET, Alexandra ULg et al

in World Journal of Gastroenterology (in press)

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See detailA European patient record study on diagnosis and treatment of chemotherapy-induced anaemia
Ludwig, H.; Aapro, M.; Bokemeyer, C. et al

in Supportive Care in Cancer (in press)

Purpose – Patients with cancer frequently experience chemotherapy‐induced anaemia (CIA) and iron deficiency (ID). Erythropoiesis‐stimulating agents (ESA), iron supplementation and blood transfusions are ... [more ▼]

Purpose – Patients with cancer frequently experience chemotherapy‐induced anaemia (CIA) and iron deficiency (ID). Erythropoiesis‐stimulating agents (ESA), iron supplementation and blood transfusions are available therapies. This study evaluated routine practice in CIA management. Methods – Medical oncologists and/or haematologists from nine European countries (n=375) were surveyed on their last five cancer patients treated for CIA (n=1730). Information was collected on tests performed at diagnosis of anaemia, levels of haemoglobin (Hb), serum ferritin and transferrin saturation (TSAT), and applied anaemia therapies. Results – Diagnostic tests and therapies for CIA varied across Europe. Anaemia and iron status were mainly assessed by Hb (94%) and ferritin (48%) measurements. TSAT was only tested in 14%. At anaemia diagnosis, 74% of patients had Hb ≤10g/dL, including 15% with severe (Hb <8g/dL) anaemia. Low iron levels (ferritin ≤100ng/mL) were detected in 42% of evaluated patients. ESA was the most commonly used treatment (63%) and 30% of ESA‐treated patients also received iron supplementation. Most iron‐treated patients (74%) received an oral iron; intravenous iron was administered to 26%. 52% of patients received transfusions and in 76% of these, transfusions formed part of a regular anaemia treatment regimen. Management practices were similar in 2009 and 2011. Conclusion – Management of anaemia and iron status in patients treated for CIA varies substantially across Europe. Iron status is only assessed in half of the patients. In contrast to clinical evidence, iron treatment is underutilised and mainly based on oral iron supplementation. Implementation of guidelines needs to be increased, particularly the minimisation of blood transfusions. [less ▲]

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See detailErythropoietin therapy after allogeneic hematopoietic cell transplantation : a prospective randomized trial
JASPERS, Aurélie ULg; Baron, Frédéric ULg; WILLEMS, Evelyne ULg et al

in Blood (in press)

We conducted a prospective randomized trial to assess hemoglobin (Hb) response to recombinant human erythropoietin (rhEPO) therapy after hematopoietic cell transplantation (HCT). Patients (n=131) were ... [more ▼]

We conducted a prospective randomized trial to assess hemoglobin (Hb) response to recombinant human erythropoietin (rhEPO) therapy after hematopoietic cell transplantation (HCT). Patients (n=131) were randomized (1:1) between no treatment (control arm) or erythropoietin (Neorecormon®) at 500 U/kg/week (EPO arm). Patients were also stratified in 3 cohorts: patients undergoing myeloablative HCT with rhEPO to start on day 28, patients given nonmyeloablative HCT (NMHCT) with rhEPO to start on day 28, and patients also given NMHCT but with rhEPO to start on day 0. The proportion of complete correctors (i.e. achieving Hb ≥ 13 g/dL) before day 126 post-transplant (primary endpoint) was 8.1% in the control arm (median not reached) and 63.1% in the EPO arm (median time 90 days) (p<0.001). Hb levels were higher and transfusions requirements decreased (p<0.001) in the EPO arm, but not during the first month in the nonmyeloablative cohort starting rhEPO on day 0. There was no difference in rates of thrombo-embolic events or other complications between the 2 arms. This is the first randomized trial to demonstrate that rhEPO therapy hastens erythroid recovery and decreases transfusion requirements when started one month after allogeneic HCT. There was no benefit to start rhEPO earlier after NMHCT. [less ▲]

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See detailImpact of co-transplantation of mesenchymal stem cells on lung function after unrelated allogeneic hematopoietic stem cell transplantation following non-myeloablative conditioning
MOERMANS, Catherine ULg; LECHANTEUR, Chantal ULg; BAUDOUX, Etienne ULg et al

in Transplantation (in press)

Background: In the context of hematopoietic stem cell transplantation (HSCT), mesenchymal stem cells (MSC) have been used to promote engraftment and prevent graft- versus-host-disease. However, in animal ... [more ▼]

Background: In the context of hematopoietic stem cell transplantation (HSCT), mesenchymal stem cells (MSC) have been used to promote engraftment and prevent graft- versus-host-disease. However, in animal models, MSC were shown to cause pulmonary alterations after systemic administration. The impact of MSC infusion on lung function has not been studied in humans. The objective of the study was to investigate the impact of MSC co-infusion on lung function and airway inflammation as well as on the incidence of pulmonary infections and cytomegalovirus (CMV) reactivation after HSCT. Methods: We have prospectively followed 30 patients who underwent unrelated HSCT with MSC co-infusion after non-myeloablative conditioning (NMA). Each patient underwent detailed lung function testing (FEV1, FVC, FEV1/FVC, RV, TLC, DLCO and KCO) and measurement of exhaled nitric oxide before HSCT and 3, 6 and 12 months posttransplant. The incidence of pulmonary infections and CMV reactivation were also monitored. This group was compared with another group of 28 patients who underwent the same type of transplantation but without MSC co-infusion. Results: Lung function tests did not show important modifications over time and did not differ between the MSC and control groups. There was a higher 1-year incidence of infection, particularly of fungal infections, in patients having received a MSC co-infusion. There was no difference between groups regarding the 1-year incidence of CMV reactivation. Conclusions: MSC co-infusion does not induce pulmonary deterioration 1 year after HSCT with NMA conditioning. MSC appear to be safe for the lung but close monitoring of pulmonary infections remains essential. [less ▲]

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See detailVaccination guidelines in hematopoietic transplant patients : recommendations from the BHS Transplant Committee
Moors, I.; Callens, S.; BEGUIN, Yves ULg et al

in Belgian Journal of Hematology (in press)

Over the past years, hematopoietic stem cell transplantation (HSCT) is increasingly used as a consolidation therapy in several haematological diseases and solid tumours. In the post-transplantation period ... [more ▼]

Over the past years, hematopoietic stem cell transplantation (HSCT) is increasingly used as a consolidation therapy in several haematological diseases and solid tumours. In the post-transplantation period, the immunity of HSCT recipients is impaired due to toxicity of the pre-HSCT treatment (chemo- and/or radiotherapy) and the conditioning regimen with reset of the immune system and – in case of allogeneic stem cell transplantation – possible graft-versus-host-disease (GVHD) and use of immunosuppressive drugs. This leads to a considerably increased risk of infections, with higher morbidity and mortality in these patients. Therefore, prevention of infections, through antibiotic prophylaxis, life style adjustments, germfree nutrition and revaccination, is of major importance to improve outcomes. In this article we present the Belgian guidelines for vaccination after hematopoietic stem cell transplantation, based on available data in the literature and international guidelines, taking into account the availability of vaccines and - if applicable - their reimbursement in Belgium. We present a general vaccination schedule for post-HSCT patients, a proposition for pre-transplant vaccination and donor vaccination, and an overview of special indications such as travel vaccinations and vaccinations of close contacts and health care workers, with guidelines for titer follow up. [less ▲]

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See detailInfusion of clinical-grade enriched regulatory T cells delays experimental xenogeneic graft-versus-host disease
Hannon, Muriel ULg; LECHANTEUR, Chantal ULg; Lucas, Sophie et al

in Transfusion (2014), 54(February), 353-363

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See detailImmunomodulatory effects of Rapamycin in xenogeneic GVHD
Ehx, Grégory ULg; HANNON, Muriel ULg; DUBOIS, Sophie ULg et al

Poster (2014, January 27)

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See detailThinking out of the box - New approaches to controlling GVHD
Baron, Frédéric ULg; Humblet-Baron, Stéphanie; Ehx, Grégory ULg et al

in Current Hematologic Malignancy Reports (2014), 9

Graft-versus-host disease (GVHD) remains a major limitation of allogeneic hematopoietic cell transplantation (allo-HCT). Despite major advances in the understanding of GVHD pathogenesis, standard GVHD ... [more ▼]

Graft-versus-host disease (GVHD) remains a major limitation of allogeneic hematopoietic cell transplantation (allo-HCT). Despite major advances in the understanding of GVHD pathogenesis, standard GVHD prophylaxis regimens continue to bebased on the combination of a calcineurin inhibitor with an antimetabolite, while first line treatmentsstill relies on high-dose corticosteroids. Further, no second line treatment has emerged thus far in acute or chronic GVHD patients who failed on corticosteroids. After briefly reviewing current standards of GVHD prevention and treatment, this article will discuss recent approaches that might change GVHD prophylaxis / treatment in the next decades, with a special focus on recently developed immunoregulatory strategies based on infusion of mesenchymal stromal or regulatory T-cells, or on injection of lowdose interleukin-2. [less ▲]

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See detailGalectin expression in the multiple myeloma microenvironment
Muller, Joséphine ULg; CAERS, Jo ULg; Binsfeld, Marilène ULg et al

in Belgian Journal of Hematology (2014)

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See detailEstablishment of a murine graft-versus-myeloma model using allogeneic stem cell transplantation.
Binsfeld, Marilène ULg; BEGUIN, Yves ULg; Belle, Ludovic et al

in Belgian Journal of Hematology (2014)

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See detailMultiple myeloma cells instruct myeloid-derived suppressor cells to release pro-angiogenic cytokines
Binsfeld, Marilène ULg; Heusschen, Roy ULg; Lamour, Virginie et al

in Belgian Journal of Hematology (2014)

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See detailHemolytic crisis induced by rasburicase administration revealing G-6-PD deficiency.
SID, Sélim ULg; Dugauquier, D.; DE PRIJCK, Bernard ULg et al

in Belgian Journal of Hematology (2014)

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See detailAntithymocyte globulin before allogeneic stem cell transplantation for progressive myelodysplastic syndrome : a study from the French Society of Bone Marrow Transplantation and Cellular Therapy
Duléry, Rémy; Mohty, Mohamad; Duhamel, Alain et al

in Biology of Blood & Marrow Transplantation (2014), 20

We investigated the impact of rabbit antithymocyte globulins (ATG) on patient outcomes after allogeneic stem cell transplantation (allo-SCT) for progressive myelodysplastic syndrome (MDS). Of the 242 ... [more ▼]

We investigated the impact of rabbit antithymocyte globulins (ATG) on patient outcomes after allogeneic stem cell transplantation (allo-SCT) for progressive myelodysplastic syndrome (MDS). Of the 242 consecutive patients who underwent allo-SCT for progressive MDS between October 1999 and December 2009, 93 received ATG (ATG group) at the median dose of 5 mg/kg, whereas 149 patients did not (no-ATG group). Donors were sibling (n ¼ 153) or HLA-matched unrelated (n ¼ 89). Patients received blood (n ¼ 90) or marrow (n ¼ 152) grafts after either myeloablative (n ¼ 109) or reduced-intensity (n ¼ 133) conditioning. Three-year overall and event-free survival, nonrelapse mortality, relapse, and chronic graft-versus-host disease (GVHD) development were not significantly different between the 2 groups. In contrast, acute grade II to IV GVHD occurred more often in the no-ATG group (55% of the patients) than in the ATG group (27%, P < .0001). Similar results were observed with acute grade III to IV GVHD (28% and 14% in the no-ATG group and ATG group, respectively; P ¼ .009). In multivariate analysis, after adjustment with propensity score, the absence of ATG was the strongest parameter associated with an increased risk of acute grade II to IV GVHD (hazard ratio, 2.13; 95% confidence interval, 1.35 to 3.37; P ¼.001]. ATG had no impact on overall and event-free survival or cumulative incidence of the relapse. In conclusion, the addition of ATG to allo-SCT conditioning did not increase the incidence of relapse of patients with progressive MDS. The incidence of acute GVHD was decreased without compromising outcomes. [less ▲]

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See detailAdequate iron chelation therapy for at least six months improves survival in transfusion-dependent patients wih lower risk myelodysplastic syndromes
Delforge, Michel; Selleslag, Dominik; BEGUIN, Yves ULg et al

in Leukemia Research (2014), 38

Background: Most patients with myelodysplastic syndromes (MDS) require transfusions at the risk of ironoverload and associated organ damage, and death. Emerging evidence indicates that iron chelation ther ... [more ▼]

Background: Most patients with myelodysplastic syndromes (MDS) require transfusions at the risk of ironoverload and associated organ damage, and death. Emerging evidence indicates that iron chelation ther-apy (ICT) could reduce mortality and improve survival in transfusion-dependent MDS patients, especiallythose classified as International Prognostic Scoring System (IPSS) Low or Intermediate-1 (Low/Int-1).Methods: Follow-up of a retrospective study. Sample included 127 Low/Int-1 MDS patients from 28 centersin Belgium. Statistical analysis stratified by duration (≥6 versus <6 months) and quality of chelation (adequate versus weak). Results: Crude chelation rate was 63% but 88% among patients with serum ferritin ≥1000 g/L. Of the 80chelated patients, 70% were chelated adequately mainly with deferasirox (26%) or deferasirox followingdeferoxamine (39%). Mortality was 70% among non-chelated, 40% among chelated, 32% among patientschelated ≥6 m, and 30% among patients chelated adequately; with a trend toward reduced cardiacmortality in chelated patients. Overall, median overall survival (OS) was 10.2 years for chelated and 3.1years for non-chelated patients (p < 0.001). For patients chelated ≥6 m or patients classified as adequatelychelated, median OS was 10.5 years. Mortality increased as a function of average monthly transfusionintensity (HR = 1.08, p = 0.04) but was lower in patients receiving adequate chelation or chelation ≥6 m(HR = 0.24, p < 0.001). Conclusion: Six or more months of adequate ICT is associated with markedly better overall survival. Thissuggests a possible survival benefit of ICT in transfusion-dependent patients with lower-risk MDS. [less ▲]

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See detailLe myélome multiple asymptomatique : le paysage thérapeutique change
CAERS, Jo ULg; BEGUIN, Yves ULg

in Oncol. Hematol. (2014), 8

Le myélome multiple est le deuxième cancer hématologique en termes de fréquence avec plus de 700 nouveaux cas chaque année en Belgique. Le myélome asymptomatique, ou smoldering mye/omo, est un stade ... [more ▼]

Le myélome multiple est le deuxième cancer hématologique en termes de fréquence avec plus de 700 nouveaux cas chaque année en Belgique. Le myélome asymptomatique, ou smoldering mye/omo, est un stade précurseur du myélome multiple. En moyenne, les patients présentant un myélome asymptomatique ont un risque annuel de progression en myélome déclaré de 10%. Différents facteul"s ont été combinés dans des modélisations pronostiques: le rapport des chaînes légères, les anomalies radiologiques, la présence d'une gammapathie évolutive et l'infiltration médullaire > 60% ont récemment été identifiés comme facteurs prédictifs d'une progression précoce pour lesquels certains auteurs évoquent la mise en roùte d'un traitement anti-myélome. Cette stratégie thérapeutique précoce a démontré son efficacité dans une étude randomisée qui comparait un traitement par lénalidornide et dexaméthasone avec une approche attentiste chez des patients à risque. [less ▲]

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See detailOutcomes of adults with active or progressive hematological malignancies at time of allogeneic stem cell transplantation : a survey from the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC)
Chevallier, P.; Labopin, M.; Milpied, N. et al

in Bone Marrow Transplantation (2014), 49

Previous data suggested that allo-SCT might be an effective therapy in the setting of chemo-refractory/relapsed diseases because of the potent long-term immune-mediated tumor control. This retrospective ... [more ▼]

Previous data suggested that allo-SCT might be an effective therapy in the setting of chemo-refractory/relapsed diseases because of the potent long-term immune-mediated tumor control. This retrospective study aimed to analyze the outcome of adult patients who received allo-SCT in a chemo-refractory/relapsed status. The series included 840 patients with active or progressive disease at the time of transplant. Median age was 50 years. With a median follow-up of 40 months, 3-year OS, disease-free survival (DFS), and non-relapse mortality rates were 29±2, 23±2, and 30±2%, respectively. At the last follow-up, 252 patients (30%) were still alive (of whom 201 were in CR (24%). In a Cox multivariate analysis, the use of a reduced-intensity conditioning (RIC) before allo-SCT and use of an HLA-identical sibling donor remained independently associated with a better OS (hazard ratio (HR)¼0.82; 95% confidence interval (CI), 0.69–0.98, P¼0.03; and HR¼0.79; 95% CI, 0.66–0.93, P¼0.006, respectively). Also, a diagnosis of myelodysplastic syndrome/myeloproliferative disorder, Hodgkin lymphoma and non-Hodgkin lymphoma compared with acute leukemia had a favorable impact on OS (HR¼0.55; 95% CI, 0.45–0.68, Po0.0001; HR¼0.49; 95% CI, 0.31–0.75, P¼0.001; and HR¼0.47; 95% CI, 0.35–0.63, Po0.0001, respectively). In conclusion, this study suggests that allo-SCT may be of benefit in some subgroups of patients with active or progressive hematological malignancies at the time of allo-SCT. [less ▲]

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