{"id":16401,"date":"2022-12-08T15:41:06","date_gmt":"2022-12-08T14:41:06","guid":{"rendered":"https:\/\/convergences.online\/hemato\/?p=16401"},"modified":"2024-12-11T18:42:21","modified_gmt":"2024-12-11T17:42:21","slug":"etoposide-et-autogreffe-dans-les-lymphomes-t-lexperience-hollandaise","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/etoposide-et-autogreffe-dans-les-lymphomes-t-lexperience-hollandaise\/","title":{"rendered":"\u00c9toposide et autogreffe dans les lymphomes T\u00a0: l\u2019exp\u00e9rience hollandaise"},"content":{"rendered":"

R\u00e9f. : HematoStat.net ; 3 (4) : R69<\/p>\n

Brink M, Meeuwes FO, van der Poel MWM, Kersten MJ, Wondergem M, Mutsaers PGNJ, et al. Impact of etoposide and ASCT on survival among patients aged <65 years with stage II to IV PTCL: a population-based cohort study. Blood. 1 sept 2022;140(9):1009\u201119.<\/a><\/i><\/p>\n

R\u00e9sum\u00e9 de l’article<\/h3>\n

Les auteurs pr\u00e9sentent une \u00e9tude de registre qui concerne les patients trait\u00e9s pour lymphome T (LT) aux Pays-Bas. Entre 1989 et 2018, 1 427 patients ont \u00e9t\u00e9 identifi\u00e9s. Dans les LT avanc\u00e9s, l\u2019ajout d\u2019\u00e9toposide au CHOP am\u00e9liorait la survie pour les patients pr\u00e9sentant une mutation de ALK mais pas pour les autres sous-types de LT. La r\u00e9alisation d\u2019une autogreffe permettait un gain de survie sauf pour les patients avec LT anaplasique \u00e0 grandes cellules ALK mut\u00e9. <\/span><\/p>\n

Dans nos pratiques<\/h3>\n

Ce vaste travail, bien que r\u00e9trospectif et men\u00e9 avant l\u2019arriv\u00e9e du brentuximab vedotin, apporte des arguments en faveur d\u2019une intensification th\u00e9rapeutique dans les LT en 1re<\/sup> r\u00e9mission compl\u00e8te (\u00e0 l\u2019exception des LT ALK positifs). L\u2019\u00e9tude TRANSCRIPT qui vient d\u2019ouvrir et proposera de randomiser la strat\u00e9gie de consolidation par chimioth\u00e9rapie seule ou une autogreffe devrait permettre de trancher (d\u00e9finitivement ?) cette question.<\/p>\n

Regard du biostatisticien<\/h3>\n

Les auteurs souhaitaient \u00e9valuer, entre autres, l\u2019impact de l\u2019autogreffe sur la survie de cette cohorte de patients, etc. Avec un suivi depuis le diagnostic ce qui peut favoriser le biais dit \u00ab d\u2019immortalit\u00e9 \u00bb. La m\u00e9thodologie statistique permet en partie d\u2019y contrevenir en \u00e9tudiant l\u2019autogreffe comme variable temps-d\u00e9pendante \u00e0 travers des r\u00e9gressions de Cox. Cela \u00e9tant, il manque dans cette publication le d\u00e9tail du d\u00e9lai entre diagnostic et autogreffe qui semble tr\u00e8s important pour l\u2019interpr\u00e9tation de certains r\u00e9sultats. De plus, la survie de toute cause des patients ne semble pas analys\u00e9e avec censure \u00e0 la greffe le cas \u00e9ch\u00e9ant (d\u00e9tail qui a son importance), les suivis sont juste censur\u00e9s \u00e0 5 ans afin d\u2019\u00e9tudier des p\u00e9riodes diff\u00e9rentes. Et, il faudra tr\u00e8s probablement, un essai de phase 3 pour conforter ces r\u00e9sultats.<\/p>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":16,"featured_media":16402,"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":[353,364,365],"ppma_author":[456],"class_list":["post-16401","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revue-de-presse","tag-brentuximab-vedotin","tag-etoposide","tag-regressions-de-cox","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\/16401","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=16401"}],"version-history":[{"count":1,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/16401\/revisions"}],"predecessor-version":[{"id":18243,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/16401\/revisions\/18243"}],"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=16401"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/categories?post=16401"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/tags?post=16401"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/ppma_author?post=16401"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}