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Le mycosis fongo\u00efde de stade avanc\u00e9 et le syndrome de S\u00e9zary sont des formes agressives de lymphomes T cutan\u00e9s primitifs, avec une survie globale m\u00e9diane inf\u00e9rieure \u00e0 5 ans. Ces maladies alt\u00e8rent consid\u00e9rablement la qualit\u00e9 de vie des patients en raison de la fatigue, des d\u00e9mangeaisons, des douleurs, des surinfections, et des modifications visibles de la peau. L\u2019effet de la greffe allog\u00e9nique de cellules souches h\u00e9matopo\u00ef\u00e9tiques avait auparavant \u00e9t\u00e9 \u00e9tudi\u00e9 dans ces maladies de mani\u00e8re r\u00e9trospective, et dans des \u00e9tudes prospectives \u00e0 petite \u00e9chelle. Ces s\u00e9ries de cas sugg\u00e9raient que la greffe induisait potentiellement un effet greffon contre lymphome (GVL) conduisant \u00e0 une r\u00e9mission durable de la maladie chez certains patients. Cependant, une rechute du lymphome post-transplantation survenait chez plus de la moiti\u00e9 des patients. De plus, l\u2019absence de groupe contr\u00f4le (patients non greff\u00e9s) dans ces \u00e9tudes rendait difficile l\u2019interpr\u00e9tation de l\u2019effet de l\u2019allogreffe sur la maladie.<\/p>\n
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En 2014, le Groupe Fran\u00e7ais d\u2019Etude des Lymphomes Cutan\u00e9s (GFELC)<\/strong> a mis en place en collaboration avec la Soci\u00e9t\u00e9 Fran\u00e7aise de Greffes de Moelle et Th\u00e9rapie Cellulaire (SFGM-TC)<\/strong> un essai clinique contr\u00f4l\u00e9 multicentrique \u00e9valuant l’allogreffe de cellules souches h\u00e9matopo\u00ef\u00e9tiques dans le traitement des patients atteints de lymphomes T cutan\u00e9s de stade avanc\u00e9 (de type mycosis fongo\u00efde et syndrome de S\u00e9zary), avec facteurs de mauvais pronostic. Il s’agissait ici d’une \u00e9tude acad\u00e9mique, financ\u00e9e par le PHRC-K, sans financement industriel. L\u2019investigateur principal \u00e9tait le Pr R\u00e9gis Peffault de Latour<\/strong> (Universit\u00e9 Paris Cit\u00e9 h\u00f4pital Saint-Louis, AP-HP), le coordonnateur scientifique le Pr Ad\u00e8le de Masson <\/strong>(Universit\u00e9 Paris Cit\u00e9, h\u00f4pital Saint-Louis AP-HP, Centre coordinateur du r\u00e9seau national INCa Lymphomes Cutan\u00e9s, ) et la m\u00e9thodologie \u00e9tait r\u00e9alis\u00e9e par le Pr Sylvie Chevret<\/strong> (Universit\u00e9 Paris Cit\u00e9 – Inserm – USPN – INRAE qui sont les tutelles du CRESS – 1153) de l\u2019Universit\u00e9 Paris Cit\u00e9.<\/p>\n Dans cette \u00e9tude, publi\u00e9e dans le Lancet le 24 avril 2023<\/strong><\/a>, \u00a0les patients \u00e9taient inclus en r\u00e9mission compl\u00e8te ou partielle de la maladie. Les patients ayant un donneur compatible pour l\u2019allogreffe recevaient une allogreffe apr\u00e8s conditionnement r\u00e9duit, et les patients n\u2019ayant pas de donneur recevaient un traitement standard, laiss\u00e9 au choix de l\u2019investigateur, sans allogreffe (groupe contr\u00f4le). Les r\u00e9sultats \u00e9taient analys\u00e9s en intention de traiter, avec un score de propension utilis\u00e9 pour tenir compte des potentiels facteurs confondants.<\/p>\n Quatre-vingt dix-neuf patients ont \u00e9t\u00e9 inclus dans 17 centres en France, 55 dans le groupe allogreffe et 44 dans le groupe contr\u00f4le. Une diff\u00e9rence significative \u00e9tait observ\u00e9e sur le crit\u00e8re de jugement principal, avec une survie sans progression significativement plus \u00e9lev\u00e9e dans le groupe allogreffe. Un b\u00e9n\u00e9fice non significatif \u00e9tait observ\u00e9 dans le groupe allogreffe sur la survie globale. Enfin, une am\u00e9lioration du score de qualit\u00e9 de vie \u00e9tait observ\u00e9e au cours du temps chez les patients allogreff\u00e9s.<\/p>\n \u00a0<\/p>\n Cette \u00e9tude est l’aboutissement de pr\u00e8s de 10 ans d\u2019un travail de collaboration entre dermatologues et h\u00e9matologues dans cette maladie rare, et un espoir pour les patients, car elle montre une augmentation de la survie sans progression des patients allogreff\u00e9s, ainsi que de la qualit\u00e9 de vie. L\u2019allogreffe se pr\u00e9sente actuellement comme le seul potentiel traitement curatif de ces maladies. La recherche et l\u2019innovation th\u00e9rapeutique dans ces lymphomes T cutan\u00e9s sont n\u00e9cessaires, pour pouvoir mener plus de patients \u00e0 la r\u00e9mission compl\u00e8te de la maladie pr\u00e9-greffe, n\u00e9cessaire pour le succ\u00e8s de l\u2019allogreffe, et la gu\u00e9rison.<\/p>\n \u00a0<\/p>\n R\u00e9f\u00e9rence\u00a0:<\/p>\n de Masson A, Beylot-Barry M, Ram-Wolff C, M\u00e9ar JB, Dalle S, d\u2019Incan M, Ingen-Housz-Oro S, et al. [\/et_pb_text][\/et_pb_column][et_pb_column type=\u00a0\u00bb1_4″][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section bb_built=\u00a0\u00bb1″ specialty=\u00a0\u00bboff\u00a0\u00bb _builder_version=\u00a0\u00bb3.21″ custom_padding=\u00a0\u00bb0px||0px|\u00a0\u00bb prev_background_color=\u00a0\u00bb#000000″ inner_width=\u00a0\u00bbauto\u00a0\u00bb inner_max_width=\u00a0\u00bbnone\u00a0\u00bb][et_pb_row _builder_version=\u00a0\u00bb3.19.11″ width=\u00a0\u00bb80%\u00a0\u00bb max_width=\u00a0\u00bb1080px\u00a0\u00bb][et_pb_column type=\u00a0\u00bb4_4″][et_pb_text admin_label=\u00a0\u00bb\u00c0 lire aussi\u00a0\u00bb _builder_version=\u00a0\u00bb3.21″]<\/p>\n [\/et_pb_text][et_pb_blog _builder_version=\u00a0\u00bb3.21″ posts_number=\u00a0\u00bb4″ include_categories=\u00a0\u00bb13″ show_author=\u00a0\u00bboff\u00a0\u00bb show_date=\u00a0\u00bboff\u00a0\u00bb show_pagination=\u00a0\u00bboff\u00a0\u00bb border_width_bottom_fullwidth=\u00a0\u00bb1px\u00a0\u00bb border_color_bottom_fullwidth=\u00a0\u00bbrgba(51,51,51,0.18)\u00a0\u00bb custom_padding=\u00a0\u00bb||50px|\u00a0\u00bb module_id=\u00a0\u00bbpage_type_blog\u00a0\u00bb header_level=\u00a0\u00bbh4″ \/][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":" Le mycosis fongo\u00efde de stade avanc\u00e9 et le syndrome de S\u00e9zary sont des formes agressives de lymphomes T cutan\u00e9s primitifs, avec une survie globale m\u00e9diane inf\u00e9rieure \u00e0 5 ans. Ces maladies alt\u00e8rent consid\u00e9rablement la qualit\u00e9 de vie des patients en raison de la fatigue, des d\u00e9mangeaisons, des douleurs, des surinfections, et des modifications visibles… Lire la suite [Publication] L’allogreffe de cellules souches h\u00e9matopo\u00ef\u00e9tiques et lymphomes T cutan\u00e9s<\/span><\/a><\/p>\n","protected":false},"author":478,"featured_media":10460,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[1,23],"tags":[],"class_list":["post-10444","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-faculte-de-sante","category-innovations"],"_links":{"self":[{"href":"https:\/\/wordpress-test.app.u-pariscite.fr\/sante\/wp-json\/wp\/v2\/posts\/10444","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wordpress-test.app.u-pariscite.fr\/sante\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wordpress-test.app.u-pariscite.fr\/sante\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wordpress-test.app.u-pariscite.fr\/sante\/wp-json\/wp\/v2\/users\/478"}],"replies":[{"embeddable":true,"href":"https:\/\/wordpress-test.app.u-pariscite.fr\/sante\/wp-json\/wp\/v2\/comments?post=10444"}],"version-history":[{"count":16,"href":"https:\/\/wordpress-test.app.u-pariscite.fr\/sante\/wp-json\/wp\/v2\/posts\/10444\/revisions"}],"predecessor-version":[{"id":10475,"href":"https:\/\/wordpress-test.app.u-pariscite.fr\/sante\/wp-json\/wp\/v2\/posts\/10444\/revisions\/10475"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/wordpress-test.app.u-pariscite.fr\/sante\/wp-json\/wp\/v2\/media\/10460"}],"wp:attachment":[{"href":"https:\/\/wordpress-test.app.u-pariscite.fr\/sante\/wp-json\/wp\/v2\/media?parent=10444"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wordpress-test.app.u-pariscite.fr\/sante\/wp-json\/wp\/v2\/categories?post=10444"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wordpress-test.app.u-pariscite.fr\/sante\/wp-json\/wp\/v2\/tags?post=10444"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Allogeneic transplantation in advanced cutaneous T-cell lymphomas: a propensity score matched
controlled prospective trial. Lancet 2023, in press<\/p>\n\u00c0<\/span> lire aussi<\/h2>\n