Normal and Leukemic Hematopoietic Stem Cells team
Hematology and cell therapy Department of Bordeaux University Hospital
keywords: French blood agency
Our department is part of the Oncology group and comprises 52 beds dedicated to inpatient Hematology care distributed as follows: 2 units with 11 positive-pressure rooms and 2 units with 15 HEPA protected rooms. In addition, we dispose of an outpatient unit providing care to more than 30 patients per day.
Patients and treatments
The department of hematology and cell therapy is the main referral centre for malignant hematological disorders in the South-West region of France. Approximately 800 new patients are treated every year. The department is entirely devoted to the care of adult patients with malignant hematological disorders: Acute Leukemia, Myelodysplastic syndromes, Myeloproliferative disorders, Multiple Myeloma, Hodgkin’s and Non Hodgkin’s Lymphoma, Chronic Lymphocytic Leukemia, Waldenström disease. The department is JACIE accredited and performs 90 to 100 allogeneic stem cell transplantations (only centre performing allogeneic stem cell transplantation in the South-West of France) and 120 to 130 autologous stem cell transplantation yearly. This represents the 4th largest haematopoietic stem cell transplant activity in France. With more than 100 new patients with acute leukemia treated each year. There are 4 weekly multidisciplinary meetings to discuss the patient clinical case: 1 is devoted to acute leukemia and MDS, 1 to Multiple Myeloma, 1 to Lymphomas and CLL,1 to the stem cell transplant program. In addition there is one monthly multidisciplinary meeting devoted to myeloproliferative disorders. Most of these meetings are regional meetings through video-conference. Dedicated pathologists, hematobiologists, molecular biologists, radiologists, isotopists, radiotherapists participate to these meetings. In addition one Clinical Research Assistant (CRA) is involved to facilitate inclusions in clinical trials.
Medical and non medical staff
- 16 hematology certified seniors including 3 professors of hematology
- 4 acute leukemia specialists : Prof A. Pigneux MD PhD, Dr T. Leguay MD, Dr PY. Dumas MD, Dr M. Robles MD
- 4 allogeneic transplant specialists : Dr S. Vigouroux MD PhD, Dr R. Tabrizi MD, Dr L. Clement MD, Dr E. Forcade MD
- 3 lymphoma and CLL specialists : Dr K. Bouabdallah MD, Dr M.S. Dilhuydy MD, Dr G. Laboure MD
- 3 myeloma specialists : Prof G. Marit MD, Dr A. Lascaux MD, Dr C. Hullin MD
- 1 MDS specialists : Dr S. Dimicoli MD PhD
- 67 registered nurses
- 1 psychologist
- 1 dietary specialist
- 1 sport adapted activity trainer
- 1 social assistant
8 full time CRA, 2 clinical research nurses. In addition, several registered nurses are participating in the clinical research activity after specific training. The department is fully organized to participate in academic and non academic clinical trials from phase 1 to phase 3 in each area of malignant hematological disorders with specialists in each area acting as Principal Investigators with the help of disease oriented CRA’s. Our department is fully accredited for Phase 1 trials by health authorities. This high clinical research activity results in the authorship of many high-ranked peer reviewed articles by the physicians working in the department.
Translational research in AML
Currently, a database of AML consisting of 220 items is established in an Access file. More than 600 patients treated in the department are indexed, containing relevant clinical and biological criteria used for the management of patients. The database is declared to the French National Commission on Informatics and Liberties (declaration n° 1777604v0), patients are indexed after informed consent (Article 40-4 of the law No. 78-17 of 6 January 1978) and in accordance with the law “Informatique et Liberté “(Article 40-5 of the law No.78-17 of 6 January 1978). Our physicians work in tight link with the INSERM Unit 1035 : Team ”Stem Cells in normal and leukemic hematopoiesis” and with the Bordeaux Biotheque Sante (BBS) bio bank which constitutes a major resource of patient samples to conduct all translational research projects (BBS is certified NF S96900).
Translational research in cell therapy
Our department has worked, for many years, in tight relation with the team of Z. Ivanovic to develop strategies to expand the CD34+ fraction of hematopoietic stem cells (HSC) from the graft. Previous studies from our centre validated the safety and efficacy of expanding the CD34+ fraction for autologous transplant in myeloma. More recently, the research team developed a process to expand the same fraction starting from Cord Blood Unit (CBU) in order to improve the number of HSC usually required for adult umbilical cord blood transplant (UCBT). This procedure was evaluated in a registered clinical trial (NCT01034449) demonstrating its feasibility and safety. This strategy was developed to reduce the number of CBU required (2 CBU are often needed in adult UCBT) and the cost of UCBT.
- Vosaroxin plus cytarabine versus placebo plus cytarabine in patients with first relapsed or refractory acute myeloid leukaemia (VALOR): a randomised, controlled, double-blind, multinational, phase 3 study. Ravandi F, Ritchie EK, Sayar H, Lancet JE, Craig MD, Vey N, Strickland SA, Schiller GJ, Jabbour E, Erba HP, Pigneux A, Horst HA, Recher C, Klimek V, Cortes J, Roboz G, Odenike O, Thomas X, Havelange V, Maertens J, Derigs HG, Heuser M, Damon L, Powell BL, Gaidano G, Carella AM, Wei A, Hogge D, Craig A, Fox J, Ward R, Smith JA, Acton G, Mehta C, Stuart RK, Kantarjian HM. Lancet Oncol. ()
- Outcome of allogeneic hematopoietic stem-cell transplantation for adult patients with AML and 11q23/MLL rearrangement (MLL-r AML). Pigneux A, Labopin M, Maertens J, Cordonnier C, Volin L, Socié G, Blaise D, Craddock C, Milpied N, Bacher U, Malard F, Esteve J, Nagler A, Mohty M. Leukemia. ()
- Peripheral blood stem cell graft compared to bone marrow after reduced intensity conditioning regimens for acute leukemia - A report from the ALWP of the EBMT. Savani BN, Labopin M, Blaise D, Niederwieser D, Ciceri F, Ganser A, Arnold R, Afanasyev B, Vigouroux S, Milpied N, Hallek M, Cornelissen JJ, Schwerdtfeger R, Polge E, Baron F, Esteve J, Gorin NC, Schmid C, Giebel S, Mohty M, Nagler A. Haematologica. ()
- Evolving characteristics and outcome of secondary acute promyelocytic leukemia (APL): A prospective analysis by the French-Belgian-Swiss APL group. Braun T, Cereja S, Chevret S, Raffoux E, Beaumont M, Detourmignies L, Pigneux A, Thomas X, Bordessoule D, Guerci A, Lamy T, Recher C, Poiré X, Tournilhac O, Spertini O, Chomienne C, Degos L, Dombret H, Adès L, Fenaux P. French-Belgian-Swiss APL Group. Cancer. ()
- Acute myeloid leukemia ontogeny is defined by distinct somatic mutations. Lindsley RC, Mar BG, Mazzola E, Grauman PV, Shareef S, Allen SL, Pigneux A, Wetzler M, Stuart RK, Erba HP, Damon LE, Powell BL, Lindeman N, Steensma DP, Wadleigh M, DeAngelo DJ, Neuberg D, Stone RM, Ebert BL. Blood. ()
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