Papers by Francoise Mechinaud
Pediatric Blood & Cancer, 2014
Describe the epidemiology, clinical profiles and outcomes associated with head and neck (H&am... more Describe the epidemiology, clinical profiles and outcomes associated with head and neck (H&N) involvement in children/adolescents with B-cell non-Hodgkin lymphoma (B-NHL). Analysis of children/adolescents with H&N B-NHL prospectively enrolled in the SFOP LMB-89 trial (July 1989-June 1996). One hundred and twelve of 561 patients (20%) had H&N involvement. The mean age of the patients was 8.4 years. Murphy staging differed between the H&N patients and the others (P < 0.0001): 9% versus 5% of the patients presented with stage I disease, 36% versus 11% presented with stage II disease, 12% versus 59% presented with stage III disease, 17% versus 10% with stage IV disease and 27% versus 16% with B-AL. Twenty-nine H&N patients (26%) had CNS involvement at diagnosis versus 8.5% in the group without H&N involvement (P < 0.0001). Patients were treated according to the LMB89 protocol: 3 H&N patients were allocated to group A, 70 to group B and 39 to group C. Ninety-seven percent of H&N patients achieved CR and event-free and overall survival at 4 years was 95.5% (5 deaths in patients with CNS disease). On multivariate analysis, EFS was significantly better in H&N patients than in non-H&N patients (P = 0.021), but not OS (P = 0.11). The H&N site is the second most common location for B-NHL at diagnosis and is more frequently associated with disseminated disease and CNS involvement than other sites. However, outcomes are no worse for these patients than for the rest of the population.
Leukemia, Jun 1, 2002
The AML1/CBFA2/RUNX1 gene is the target of many recurrent translocations seen in different leukem... more The AML1/CBFA2/RUNX1 gene is the target of many recurrent translocations seen in different leukemia subtypes. The t(12;21)(p13;q22) is the most frequent translocation observed in childhood B acute lymphoblastic leukemia (ALL), occurring in 20% to 25% of cases. In adult ALL this rearrangement is scarce. Another route of AML1 deregulation could be point mutations in the runt domain. We now report on AML1 amplification in two cases of childhood ALL, found in a series of 107 consecutive children with B-lineage ALL analyzed by fluorescence in situ hybridization (FISH). A parallel analysis of 42 adult B-ALL failed to detect any AML1 rearrangement by FISH. The two patients with AML1 amplification were further analyzed using molecular techniques. SSCP analysis did not detect any mutation. Furthermore, direct sequencing of the cDNA did not reveal any mutation. In conclusion, AML1 amplification seems to be observed only in childhood ALL and is not associated with AML1 gene mutation. Other mechanisms, such as gene dosage effects could be hypothesized.
Data Revues 0929693x 00140006 07001224, Jun 1, 2007
L'annonce est une étape décisive de la prise en charge en oncologie pédiatrique. Elle est décisiv... more L'annonce est une étape décisive de la prise en charge en oncologie pédiatrique. Elle est décisive à double titre, d'une part, par la charge émotionnelle qu'elle mobilise à court et long terme et d'autre part, par l'impact qu'elle a dans le consentement de l'enfant et de ses parents au projet de soin. Ce consentement suppose une compréhension suffisante des enjeux pour participer à la décision. La charge émotionnelle est une entrave à une intégration optimale des enjeux. Émotion et raison doivent cohabiter. En ces termes, l'annonce résume la complexité du soin à l'autre qui doit allier une dimension technique et scientifique avec sa plus grande rigueur et une dimension d'humanité et de bienveillance. Le moment de l'annonce est le moment où la vie de la famille bascule brutalement. C'est comme si la famille entrait soudain dans un nouvel espace social : celui de la maladie. C'est pour l'aider dans ce cheminement que le dispositif d'annonce a été pensé dans le cadre du plan Cancer. L'annonce doit accompagner ce qui s'inscrit dans une rupture avec de nouveaux repères, mais aussi dans le même temps préserver la continuité.
Ash Annual Meeting Abstracts, Nov 16, 2004
Among 100 patients with acute lymphoblastic leukemia (ALL), 15 B-ALL patients were found positive... more Among 100 patients with acute lymphoblastic leukemia (ALL), 15 B-ALL patients were found positive for surface Her2/neu expression. The incidence in children was only 3.4% compared to 31% in adults (p=0.001). Considering only adult B-ALL patients (n=38), surface Her2/neu expression was associated with chemoresistance (50% versus 11%, p=0.03) suggesting that it could be a prognostic marker of poor clinical outcome in ALL.
Medical and Pediatric Oncology, Jun 1, 1996
The Rothmund-Thomson syndrome (RTS), also called poikiloderma congenitale is a rare autosomal rec... more The Rothmund-Thomson syndrome (RTS), also called poikiloderma congenitale is a rare autosomal recessive disease first described in 1868. This syndrome includes most frequently seen skin lesions (atrophy, telangiectases, pigmentation), cataracts and bone defects (dysostosis, dysplasia). Some authors describe an association with malignancy. We report three cases of Rothmund-Thomson syndrome associated with osteosarcoma. After cutaneous epithelioma, osteosarcoma is the most frequent malignancy. Thus, patients with RTS need a careful survey. The treatment did not differ from sporadic osteosarcoma. Chemosensitivity and toxicity are also not different.
Pediatric Blood & Cancer, 2016
The treatment of children with T-cell lymphoblastic lymphoma (T-LBL) and precursor B-cell lymphob... more The treatment of children with T-cell lymphoblastic lymphoma (T-LBL) and precursor B-cell lymphoblastic lymphoma (pB-LBL) has improved during the last decades. However, patients with relapsed or refractory lymphomas still have a poor prognosis. We report the characteristics and evolution of T-LBL and pB-LBL relapses in two multicenter prospective studies (LMT 96, European Organization for Research and Treatment of Cancer 58951). From 1997 to 2008, 194 patients were included in these studies (157 T-LBL; 37 pB-LBL); among them, 23 patients underwent relapse or progression (18 T-LBL and 5 pB-LBL). The median age was 7.7 years (range 1.4-16.3). The survival rate at 8 years was 8.7% (21 deaths). The median time from diagnosis to relapse was 9 months [1-69] and 11 months [1-45] for T-LBL and pB-LBL, respectively. Twenty-two patients received a second-line treatment but remission was achieved in only seven patients. In 10 patients, intensification with hematopoietic stem cell transplantation (HSCT) was performed and four of them had a second relapse. Two patients still alive had T-LBL, experienced relapses 15 and 69 months after diagnosis, and received HSCT. Relapse during the intensive phase and second-line treatment without HSCT were identified as risk factors for bad prognosis (P = 0.01). The results of second-line treatment, including intensive chemotherapy and HSCT, show that salvage treatment is still disappointing in controlling refractory forms. Early identification of patients at high risk of relapse is mandatory, allowing earlier intensification. Valid prognostic parameters, such as biological markers, are needed. International cooperation is warranted to collect more data on these rare diagnoses.
Bailli Egrave Re S Best Practice and Research in Clinical Haematology, Jan 6, 2000
Haemophagocytic syndromes (HS) are the clinical manifestation of an increased macrophagic activit... more Haemophagocytic syndromes (HS) are the clinical manifestation of an increased macrophagic activity with haemophagocytosis. Pathophysiology is related to a deregulation of T-lymphocytes and excessive production of cytokines. The main clinicobiological features are fever, hepatosplenomegaly, adenopathies, skin rash, neurological features, cytopenias, hypertriglyceridaemia, hyperferritinaemia and coagulopathy. Diagnosis is based on examination of the bone marrow which shows benign histiocytes actively phagocytosing haemopoietic cells. Acquired HS are mostly associated with an underlying disease such as immunodeficiency, haematological neoplasias and autoimmune diseases. Infection-associated HS was originally described by Risdall in 1979, in viral disease. Since the initial description HS has also been documented in patients with bacterial, parasitic or fungal infections. Epstein-Barr virus (EBV) is the causative agent in most cases. In EBV-associated HS, which sometimes has a fatal course, unregulated T-cell reaction or uncontrolled B-cell proliferation may release cytokines. Management of HS consists of early diagnosis, careful screening for, and prompt treatment of, infections and detection and therapy of any underlying disease. Prognosis of infection-associated haemophagocytic syndrome (IAHS) is better than that in other types of secondary HS. Management of cytokine imbalance should be useful to improve the outcome and reduce the mortality rate in these cases.
Guillem et al., Human Mutation 1 Supp. . Membrane localization of WT MT2 and IRIDA variants in Hu... more Guillem et al., Human Mutation 1 Supp. . Membrane localization of WT MT2 and IRIDA variants in Huh7 cells. Huh7 cells were transiently transfected with an empty vector (mock), WT MT2-FLAG, and MT2-FLAG mutants: Y418C, L235P, P765A, E114K, A605fs. Immunofluorescence detection of the expressed protein was performed using rabbit polyclonal anti-FLAG antibody and anti-rabbit secondary antibody labeled with FITC (green) in non-permeabilized cells, as described in the method section.
Bulletin Du Cancer, Mar 4, 1997
... Auteur(s) : Sophie Dupuis-Girod, Olivier Hartmann, Ellen Benhamou, François Doz, Françoise Me... more ... Auteur(s) : Sophie Dupuis-Girod, Olivier Hartmann, Ellen Benhamou, François Doz, Françoise Mechinaud, Eric Bouffet, Carole Coze, Chantal Kalifa, Service d ... central sur les fonctions cognitives sont bien connus (Duffner et al., 1983 ; Meadows et al., 1981 ; Mulhern, et Kun ...
Bulletin Du Cancer, Mar 4, 1997
Archives françaises de pédiatrie
Nouvelle revue française d'hématologie
Cerebral aspergillosis has a very poor prognosis. When this complication occurs in the immunocomp... more Cerebral aspergillosis has a very poor prognosis. When this complication occurs in the immunocompromised host, evolution is virtually fatal in all cases despite surgical and medical treatment. We describe in this report the case of a child with acute lymphoblastic leukaemia who developed pulmonary aspergillosis, and subsequent cerebral dissemination during therapeutic induction. Due to multifocal cerebral lesions, surgery was impossible. The patient was administered long term treatment including amphotericin B, flucytosine and itraconazole for 9 months, during which time a neutropenic period occurred with reactivation of cerebral mycotic lesions, in spite of modification of antileukaemic therapy. Seven years later, he nevertheless remains in complete remission without any neurological sequelae. Thus cerebral aspergillosis requires early diagnosis and can be treated using a strong combination of antimycotic drugs (amphotericin B, flucytosine and itraconazole) on a long term basis, even when aspergillomas cannot be removed surgically. Antileukaemic therapy must be concomitantly adapted to avoid or limit neutropenia.
Archives françaises de pédiatrie
American Journal of Clinical Pathology
ABSTRACT
La Revue de Médecine Interne
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Papers by Francoise Mechinaud