{"id":15635,"date":"2021-12-14T07:00:42","date_gmt":"2021-12-14T06:00:42","guid":{"rendered":"https:\/\/convergences.online\/hemato\/?p=15635"},"modified":"2024-12-11T14:24:12","modified_gmt":"2024-12-11T13:24:12","slug":"hematopoiese-clonale-et-neutropenie-chronique","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/hematopoiese-clonale-et-neutropenie-chronique\/","title":{"rendered":"H\u00e9matopo\u00ef\u00e8se clonale et neutrop\u00e9nie chronique"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1302px;margin-left: calc(-5% \/ 2 );margin-right: calc(-5% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.375%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:2.375%;--awb-width-medium:100%;--awb-spacing-right-medium:2.375%;--awb-spacing-left-medium:2.375%;--awb-width-small:100%;--awb-spacing-right-small:2.375%;--awb-spacing-left-small:2.375%;\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><p>R\u00e9f. : HematoStat.net ; 2 (4) : R35<\/p>\n<p><em>Tsaknakis G et al. <\/em><em>Incidence and prognosis of clonal hematopoiesis in patients with chronic idiopathic neutropenia. Blood. 7 oct 2021;138(14):1249<\/em><em>\u2011<\/em><em>57.<\/em><\/p>\n<p><strong>R\u00e9sum\u00e9 de l&#8217;article<\/strong><\/p>\n<p>Certains patients pr\u00e9sentent des neutrop\u00e9nies chroniques isol\u00e9es qui, en l\u2019absence d\u2019\u00e9l\u00e9ment \u00e9tiologique identifi\u00e9, peuvent \u00eatre regroup\u00e9es sous le terme de neutrop\u00e9nie chronique idiopathique (CIN). La pr\u00e9valence des mutations somatiques chez ces patients est mal connue. Une analyse NGS avec un panel my\u00e9lo\u00efde (40 ou 54 g\u00eanes) \u00e9taient r\u00e9alis\u00e9e sur 185 patients atteints de CIN. Vingt et un patient (11,35 %) pr\u00e9sentaient des mutations ; DNMT3A et TET2 repr\u00e9sentaient 80% des mutations.<\/p>\n<p><strong>Dans nos pratiques<\/strong><\/p>\n<p>Des r\u00e9sultats rassurants concernant ce motif relativement fr\u00e9quent de consultation. Seuls 5 patients sur 185 (2,70 %) ont pr\u00e9sent\u00e9 une \u00e9volution vers une h\u00e9mopathie my\u00e9lo\u00efde ; parmi eux 4 pr\u00e9sentaient d\u00e9j\u00e0 au moins une mutation clonale au d\u00e9part (soit un risque relatif de 31,2, p=0,0017). La neutrop\u00e9nie n\u2019\u00e9tait pas plus s\u00e9v\u00e8re chez les patients pr\u00e9sentant des marqueurs de clonalit\u00e9 par rapport au reste de la cohorte.<\/p>\n<p><strong>Le regard du statisticien<\/strong><\/p>\n<p>La vis\u00e9e de cette \u00e9tude \u00e9tait exploratoire afin de d\u00e9crire les diverses mutations, voire d\u2019\u00e9tablir des hypoth\u00e8ses apr\u00e8s recherche de mutations (g\u00e8nes, types d\u2019all\u00e8le, etc.) chez cette population tr\u00e8s particuli\u00e8re de patients. Tr\u00e8s peu de patients ont vu leur maladie \u00e9voluer ce qui peut aboutir \u00e0 des r\u00e9sultats parfois significatifs mais avec des intervalles de confiance tr\u00e8s larges et une puissance faible. Attention donc \u00e0 ne pas sur-interpr\u00e9ter.<\/p>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":16,"featured_media":15636,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[36],"tags":[204,205,206,207],"ppma_author":[456],"class_list":["post-15635","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revue-de-presse","tag-hemopathie-myeloide","tag-intervalles-de-confiance","tag-neutropenies","tag-puissance","author-alexis-genthon"],"aioseo_notices":[],"authors":[{"term_id":456,"user_id":16,"is_guest":0,"slug":"alexis-genthon","display_name":"Alexis GENTHON","avatar_url":{"url":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-14.25.02.png","url2x":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-14.25.02.png"},"first_name":"","last_name":"","user_url":"","description":"H\u00e9matologue.\r\nCorrespondance : H\u00f4pital Saint-Antoine \r\nService h\u00e9matologie clinique\r\n184 rue du Faubourg Saint-Antoine 75012 Paris."}],"_links":{"self":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15635","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/comments?post=15635"}],"version-history":[{"count":1,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15635\/revisions"}],"predecessor-version":[{"id":18204,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15635\/revisions\/18204"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/"}],"wp:attachment":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/media?parent=15635"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/categories?post=15635"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/tags?post=15635"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/ppma_author?post=15635"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}