Emerging drugs for prevention of graft failure after allogeneic hematopoietic stem cell transplantation

in Expert Opinion on Emerging Drugs (in press)

Introduction: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the treatment of choice for many patients suffering from hematological malignancies, severe hemoglobinopathies, bone marrow ... [more ▼]

Introduction: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the treatment of choice for many patients suffering from hematological malignancies, severe hemoglobinopathies, bone marrow failures or severe primary immunodeficiencies. Graft rejection/failure (GF) is a life-threatening complication following allo-HSCT that is most commonly caused by the reactivity of recipient T cells, natural killer (NK) cells or antibodies against donor grafted hematopoietic cells. The increasing use of allo-HSCT following reduced-intensity conditioning (RIC) and the increasing use of alternative donors (unrelated cord blood and human leukocyte antigen (HLA)-mismatched donor) have resulted in higher frequency of GF. Areas covered: This review describes the pathogenesis and current prevention and treatment of GF as well as agents in development for GF prevention or treatment. Expert opinion: The risk of GF may be reduced in the future by optimizing the conditioning regimens and post-grafting immunosuppression, increasing the number of hematopoietic stem cells (HSCs) and/or immune cells transplanted, optimizing HSC homing and better detecting patients at high risk of GF by searching for pre-transplant donor-specific anti-HLA antibodies in patients given grafts from HLA-mismatched donors, or by closely monitoring donor T- and/or NK-cell chimerism after allo-HSCT following RIC. [less ▲]

Longitudinal Monitoring of Immune Reconstitution after Allogeneic Peripheral Blood Stem Cell Transplantation (PBSCT): Impact of T-Cell Depletion of the Graft

in Biology of Blood & Marrow Transplantation (2012, February), 18(2), 274-275

Comment j'explore... une fièvre d'origine indéterminée chez le patient adulte ?

in Revue Médicale de Liège (2012), 67(7-8), 391-397

Fever of unknown origin (FUO), with more than 200 potential causes, can represent a real diagnostic challenge.For the work-up of FUO, the first step is to pay attention to each element revealed by a ... [more ▼]

Fever of unknown origin (FUO), with more than 200 potential causes, can represent a real diagnostic challenge.For the work-up of FUO, the first step is to pay attention to each element revealed by a detailed history, a complete physical examination and by some basic diagnostic tests. These elements may constitute some clues that can guide the physician for the prescription of further appropriate diagnostic examinations and procedures. If there is no real specific clues,a pet-scan seems to be useful for the work-up of FUO. [less ▲]

Rituximab et maladie du greffon contre l'hôte chronique

in Horizons Hemato (2012), 2(2), 78-81

La maladie du greffon contre l’hôte (« greffe-versus-hôte » – GVH) chronique (GVHc) est une complication fréquente des allogreffes de cellules souches hématopoïétiques (CSH). A l’heure actuelle, à ... [more ▼]

La maladie du greffon contre l’hôte (« greffe-versus-hôte » – GVH) chronique (GVHc) est une complication fréquente des allogreffes de cellules souches hématopoïétiques (CSH). A l’heure actuelle, à l’exception des corticostéroïdes, peu de traitements se sont avérés réellement efficaces pour la prise en charge de la GVHc. Des données récentes suggèrent un rôle important des lymphocytes B (LB) dans la physiopathologie de la GVHc. Elles constituent le rationnel scientifique à une série d’études évaluant l’efficacité du rituximab, un anticorps monoclonal dirigé contre l’antigène CD20 exprimé à la surface des LB, dans la prévention ou le traitement de la GVHc. [less ▲]

Reduced intensity conditioning for allogeneic hematopoietic stem cell transplantation (HSCT)

in Belgian Journal of Hematology (2011), 2

Reduced intensity conditioning (RIC) regimens have allowed performing allogeneic haematopoietic stem cell transplantation (HSCT) in patients for whom conventional myeloablative allogeneic HSCT is ... [more ▼]

Reduced intensity conditioning (RIC) regimens have allowed performing allogeneic haematopoietic stem cell transplantation (HSCT) in patients for whom conventional myeloablative allogeneic HSCT is associated with unacceptable risks of non-relapse-mortality. This approac relies mainly on graft-versus-tumour effects for tumour eradication. Retrospective studies have suggested that, in patients aged 40 to 60 years, RIC-HSCT was associated with a higher risk of relapse but a lower incidence of transplant-related mortality than myeloablative allogeneic HSCT, leading to similar progression-free and overall survivals. After reviewing the rationale for RIC-HSCT, this article discusses the results of RIC-HSCT in specific deseases, and proposes what could be current indications for RIC-HSCT in 2011. Finally, the article briefly presents some possible strategies aimed at increasing the anti-tumoral activity of the procedure while reducing the incidence and severity of acute graft-versus-host disease. [less ▲]

Enteroviral meningoencephalitis as complication of Rituximab therapy in a patient treated for diffuse large B-cell lymphoma

in British Journal of Haematology (2010), 150(3), 379-381

Trouble obsessionnel-compulsif (TOC).

in Revue Médicale Suisse (2009), 5(214), 1659-62

Obsessive compulsive disorder (OCD) is a frequent and disabling psychic illness. Along psychiatric history, several etiological models have been successively hypothesized to explain the obsessive ... [more ▼]

Obsessive compulsive disorder (OCD) is a frequent and disabling psychic illness. Along psychiatric history, several etiological models have been successively hypothesized to explain the obsessive compulsive symptoms from a psychological, behavioural or biological point of view. This review aims at presenting OCD etiological models as well as describing OCD clinical and therapeutic aspects. [less ▲]

La thrombose veineuse cérébrale.

in Revue Médicale de Liège (2008), 64

La thrombose veineuse cérébrale est une cause rare d'accident vasculaire cérébral. La clinique est peu spécifique et polymorphe. L'imagerie médicale permet de poser le diagnostic dans la majorité des cas ... [more ▼]

La thrombose veineuse cérébrale est une cause rare d'accident vasculaire cérébral. La clinique est peu spécifique et polymorphe. L'imagerie médicale permet de poser le diagnostic dans la majorité des cas. En particulier, la vénographie par une résonance magnétique est très sensible et constitue, actuellement, l'examen de référence. Le pronostic à long terme est généralement bon et peu de patients gardent des séquelles. Néanmoins, le décours est imprévisible. La prise en charge thérapeutique s'organise selon trois axes : le traitement anti-thrombotique, symptomaique et étiologique. [less ▲]