972 resultados para Leucemia mileóide aguda Genética
Resumo:
Introduo e Objetivos: O sistema nervoso central (SNC) o um stio freqente de recada na criana com leucemia linfoctica aguda (LLA). Existe evidncia de que a puno lombar traumtica (PLT) pode representar um risco adicional de recada no SNC quando ocorre inoculao de blastos no liqido cfalorraquidiano (LCR). Este estudo tem por objetivo determinar se a ocorrncia da PLT ao diagnstico afeta o prognstico de pacientes com essa patologia. Material e Mtodos: Setenta e sete pacientes com diagnstico de LLA, tratados entre 1992 a 2002, foram includos na anlise. Quimioterapia intratecal (QIT) foi instilada imediatamente aps a PL inicial (precoce), ou na segunda PL (tardia), realizada no perodo de 24 a 48 horas aps a realizao da PL inicial. Foi feita anlise da influncia da PLT e do momento (precoce x tardia) de administrao da QIT em relao a recada no SNC. Resultados: Entre os 19 pacientes que apresentaram PLT ao diagnstico e receberam QIT tardia, seis tiveram recada isolada no SNC e dois recada combinada em SNC e medula ssea (MO). Entre os nove pacientes que tiveram PLT e receberam QIT precoce, somente um apresentou recada combinada em SNC e MO (P=0,20); no houve, portanto, influncia estatisticamente significativa da PLT na sobrevida livre de eventos (SLE) (55% para QIT precoce x 49% para QIT tardia) (P=0,37). Entretanto, em anlise estratificada, de acordo com grupos de risco, observamos que para pacientes de baixo ou mdio risco o OR foi de 0,8 quando recebiam QIT tardia (P=0,99) e 0,17 quando recebiam QIT precoce (P=0,47). Por outro lado, entre pacientes de alto risco o OR para recada foi de 21,0 para aqueles que recebiam QIT tardia (P=0,09) e 1,5 para o grupo que recebia Q IT precoce (P=0,99). Concluso: Os resultados do presente estudo so sugestivos de que a ocorrncia da PLT tem uma influncia adversa no prognstico de pacientes com LLA de alto risco de recada. Como estes resultados so decorrentes de um estudo retrospectivo, recomenda-se que sejam confirmados em estudos prospectivos randomizados.
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A leucemia mielide aguda (LMA) acomete pacientes de todas as faixas etrias com freqncia aumentada em idosos. Nosso estado no apresenta registros sistemticos da patologia, justificando-se desta forma o levantamento atravs dos centros de diagnstico e tratamento, os quais concentram a maioria dos casos. Foram includos todos os pacientes com diagnstico de LMA de novo levantados a partir dos registros dos centros de diagnstico e tratamento da patologia no estado no perodo entre 1996 e 2000. Foram computados no perodo 532 pacientes (taxa estimada de 1,04 casos / 100.000 habitantes / ano). A idade mdia ao diagnstico foi 41,0 anos e 46,6 % dos casos eram do sexo masculino. Houve distribuio semelhante nas 7 mesorregies geogrficas do estado. Em relao ao nmero de casos por faixa etria, observou-se uma taxa estimada em 0,5 1 caso / 100.000 habitantes at a faixa etria dos 45 anos, atingindo 3,5 casos / 100.000 habitantes na faixa etria igual ou superior a 70 anos. A sobrevida mdia considerando todos os casos foi de 17%, aumentando para 25% considerando a populao abaixo de 60 anos e alcanando 40% na populao entre 10 e 20 anos. Tais dados evidenciam uma distribuio semelhante por regio, estimativa de incidncia na faixa infantil semelhante a pases desenvolvidos e bastante menor na populao idosa. A mortalidade geral foi semelhante quela relatada na literatura.
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Coordenao de Aperfeioamento de Pessoal de Nvel Superior
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The acute myeloid leukemia (AML) is a disease in which malignant myeloblasts expand, build up and suppress normal hematopoietic activity would represent a major diagnostic challenge. With the advent of immunophenotyping by flow cytometry, the diagnosis of these tumors have become more faithful, facilitating the treatment and monitoring of patients. The objectives of this study: diagnosis and classification of AML based on immunophenotyping by flow cytometry with a panel of AcMo specific for acute leukemias, set the frequency of AML in samples from patients with acute leukemias sent to the Department of Hematology Blood Center of Rio Grande do Norte - HEMONORTE, establish standards of antigen expression for different subtypes of acute leukemia and its correlation with the newly diagnosed cases refractory to treatment and recurrence of the disease, standardization of methods for detection and labeling of surface antigens by flow cytometry and intracytoplasmic flow, and observe the frequency of acute leukemia with aberrant phenotypes rare. During the study, 351 were diagnosed acute leukemia, and 179 (51%) classified as AML and 172 (49%) and ALL, which were excluded from the present work. Of the 179 AML, 92 (51.4%) were female and 87 (48.6%) were male, with ages ranging from 3 to 95 years of ag, with higher incidence in individuals in the age group of 41 to 65. Splenomegaly was the clinical finding more present, a total of 147 cases (82.1%), followed by hepatomegaly present in 132 cases (73.7%). The hemorrhagic events were observed in 55 cases (30.7%). Lymphadenopathy in turn was detected in 20 of 179 cases (11.2%). In order to classify subtypes of AML, we used a large panel of monoclonal antibodies, obtaining the following results: AML M0, 02 (1.1%) AML M1, 40 (22.3) AML M2, 60 (33.5) AML M3, 22 (12.3%) AML M4, 10 (5.6) AML M5, 13 (7.3%) AML M6 06 (3.4%) and AML M7 01 (0.6%). We observed some cases with aberrant expression of some antigens such as CD7, CD4, CD19, CD3, CD5 and TdT, CD 7 was present in 30 (16.8%), CD4 in 5 (2.8%), the CD 3 in 5 (2.8%), the CD19 in 3 (1.7%), the CD5 in 3 (1.7%) and TDT was in 7 (3.9%) cases of AML .the CD8 and CD79a was present in only a 1 case.
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Leukemia is a heterogeneous group of hematologic malignancies that result from partial or total transformation of the blast cells. The Acute Lymphoblastic Leukemia (ALL) is the most common malignancy in childhood, especially in male, Caucasian children younger than 14 years. Several criteria are adopted to classify ALL, including the cell morphology, cytochemistry, immunophenotyping and cytogenetic analysis. Cytogenetic studies allow a more detailed analysis to detect chromosomal abnormalities of leukemic cells. These modifications will determine the diagnosis, classification, stage characterization, remission assessment and prognosis. In this study were evaluated 30 patients, aged from four months to seventeen years, of both sexes and various ethnicities. The age distribution showed that 67% of patients had between one and ten years (with mean age of XX years old), the most prevalent ethnic was Caucasian (50%) and 57% were males. According to immunophenotype, 93% of patients had B-cells progenitor ALL and 7% early lineage T. Considering the total studied population, the most frequent medical findings were lymphadenopathy (37%), hepatomegaly (77%) and splenomegaly (70%), where one patient could present more than one of these medical findings. Regarding the CBC, the majority of patients had hemoglobin below 10 g / dl (73%), leukocyte count less than 10.000/μL (60%) and platelet count below 150.000/μL (83%). Chromosomal abnormalities were observed in 64% of all patients, where hyperdiploidy was the most common numerical change (67%), followed by hypodiploid (33%). All these data are in agreement with the literature. Moreover, complexes structural and/or number changes not yet described in literature were observed, which indicated poor prognosis. Finally, we concluded that this study demonstrated the importance of cytogenetic study in the diagnosis and identification of prognostic factors in pediatric patients with ALL in Rio Grande do Norte. The results obtained in this study are extremely useful and emphasizes that surveys of this nature must be conducted more frequently in our state
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Regarding the morbidity potential of oral complications in patients with leukemia, it evaluated the clnical and microbiologic changes of oral mucosal in children with LLA, with age range of O to 15 years old, undergone the chemotherapy antineoplastic and for the use prophylactic of chlorhexidine gluconate 0,12% during ten days, that was utilized in each chemotherapy treatment stage. The collect for rnicrobiological study was obtained preferentiality in intensification stage at the end prophylatic treatment. The study grouup had 20 children, where it observed clinically decrease in frequency of mucositis, with 8 cases (40%) only. In microbiological examination observed one reduced incidence of pathogenic microorganisms with Staphylococcus coagulase- negative (40%), Klebsiella pneumoniae (5%), Escherichia coZi enteropathogenic (15%), Stenotrophomonas maltophilia (5%) e Candida albicans (35%). The findings obtained in the present trial suggest that the use of chlorhexidine gluconate 0,12% can be responsible for incidence reduced of mucositis, but it wasn t possible to make correlation between isolated pathogenic microorganisms and mucositis development
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The present work investigated the cognitive operation of children diagnosed with acute lymphoblastic leukaemia (ALL), accompanied at pediatric oncologic institutions at the city of Natal/RN. Had participated in this study twenty children, of both sexes, between six and twelve years old, with the ALL diagnostic, who were in treatment (n=10) and out of treatment for at least one year (n=10) and were submitted exclusively to chemotherapy as CNS prophylaxis. The utilized protocol of neuropsychological evaluation covered the following cognitive abilities: intellective capability, attentional and memory systems, and executive functions. Data was analyzed through descriptive and inferential measures, with the support of the Mann-Whitney U Test and T-test, considering the influence of the variables sex, age at diagnostic and the past time since the beginning of the treatment over children s performance. The intellective capability evaluation showed low score to the out-of-treatment groups, female and children under five years old to the diagnostic. In concern of attentional systems, groups showed the expected performance. In a relevant way, in the evaluation of executive functions, were found reduced scores within all groups, especially inside the in-treatment group. Memory evaluation pointed to reduced performance in items concerning to learning evolution and spontaneous evocation after interference to the several groups. It can be concluded, reffer to the occurrence of transitory and permanent impact associated to the intrusion of chemotherapic components during the maturational course of the CNS. It s expected that the present investigation and the development of similar studies enable major comprehension about the mode, extension and repercussion of these damages subsidizing the development of strategies which may minimize them and provide better xxiii life quality to this clinical subgroup
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The present study investigated the impact of the treatment modalities of Acute Lymphoblastic Leukemia on neurocognitive abilities of children and adolescents survivors, aged between 6 and 16 years of age, accompanied in pediatric oncology sectors of public health services in the cities of Campina Grande-PB and Natal-RN. The study included 52 children, 13 of these being children and adolescents diagnosed with leukemia and 39 healthy children matched in relation to the study group considering gender, age, school type and level of maternal education. Later the group of children with leukemia was subdivided into two subgroups depending on treatment modality which were submitted: Group 1A (only chemotherapy) and 1B (chemotherapy and radiotherapy). All participants were subjected to a battery of neuropsychological tests that investigated the following neurocognitive abilities: intellectual ability, memory system, attention, visuospatiality and visuoconstruction, processing speed and executive functions. Data were analyzed using descriptive and inferential measurements with the aid of the U test of Mann-Whitney and T test, considering the influence of the variables: sex, age at diagnosis, time since completion of treatment and level of schooling mothers, on the performance of children. Overall, it is concluded that the illness and the treatment of acute lymphoblastic leukemia significantly favors the emergence of cognitive deficits, particularly in terms of visuospatial skills, and executive skills visoconstrutivas. In turn, the treatment modality of radiotherapy is associated with the presence of more severe deficits, highlighting the significant impact on the speed of information processing. It is hoped that the results presented here will contribute to a better understanding of the nature and extent of neurocognitive effects arising ALL treatment
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Os vrus linfotrpicos de clulas T humanas do tipo I e II (HLTV-I/II) apresentam genoma de cido ribonuclico (RNA) e infectam geralmente clulas CD4+, com relao endmica em determinadas reas como Japo e Caribe com predomnio maior ou menor em outras regies; na Amaznia brasileira as pesquisas esto correlacionadas principalmente populao indgena. Estes vrus esto associados a doenas malgnas, desordens neurolgicas e imunodeficincias, ocasionando viremia por longo perodo, sem manifestaes clnicas. O HTLV considerado agente etigico da Leucemia/ linfoma de clula T do adulto (L/LTA) e Parapasemia esptica tropical/Mielopatia associada ao HTLV-I (PET/HAM) dentre outras. Este estudo tem como objetivo investigar a presena de HTLV e determinar o tipo mais freqente (HTLV-I ou HTLV-II) em crianas com Leucemia Linfide Aguda, matriculadas no servio de referncia para Cncer em Belm, observando a via de transmisso pelo aleitamento materno, os sintomas neurolgcas relacionados com a infeco a reviso bibliogrfica pertinente. A pesquisa dos vrus foi realizada pela tcnica de PCR (Reao em Cadeia da Polimerase), que permite a distino entre HTLV-I e HTLV-II. Foram observados os parmetros de idade, sexo, leses cutneas, marcha e transfuso sangunea atravs de porcentagens. O HTLV-I foi positivo em uma criana do sexo feminino, sem relao com transmisso por aleitamento materno, e no houve o envolvimento do HTLV como agente etiolgico de neoplasia de clulas linfide na faixa etria peditrica.
Resumo:
Despite the advances in the cure rate for acute myeloid leukemia, a considerable number of patients die from their disease due to the occurrence of multidrug resistance (MDR). Overexpression of the transporter proteins P-glycoprotein (Pgp) and multidrug resistance-associated protein (MRP) confer resistance to the treatment these leukemias. OBJECTIVE: To analyze the expression of the Gpp and MRP1 in patients with AML by flow cytometry (FC) and to determine the correlation between expression and demographic and also clinical and laboratorial variables. METHODS: Bone marrow and peripheral blood samples from 346 patients with a diagnosis of AML were assessed for the expression of Pgp and MRP1 by FC. RESULTS: The expression of Pgp and MRP1 was found in 111 (32.1%) and 133 (38.4%) patients, respectively, with greater prevalence in older patients and lower in adolescents, observing also a high incidence in patients with refractory disease, recurrence and secondary in comparison with the cases of de novo AML. Regarding the laboratory findings, we observed a higher correlation statistically significant between the expression of Pgp and MRP1 in AML CD34+ and FAB AML M7, M5A and M2 and lower the M3 subtype, not observed statistically significant correlation between the phenotype MDR and other laboratory data such with hemoglobin, leukocyte count, platelet count, aberrant expression of lymphoid antigens (CD2, CD7 and CD19) and clinical signs related to the disease. CONCLUSIONS: The results showed that the detection of MDR phenotype by flow cytometry can be a molecular marker for prognosis independent patients diagnosed with AML.
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La leucemia mieloide aguda (LMA) es un desorden caracterizado por clulas progenitoras mieloides en mdula sea, infiltracin de la sangre perifrica y otros tejidos por clulas neoplsicas del sistema hematopoytico. En la etiologa de la LMA interviene la herencia, la radiacin, las exposiciones qumicas o laborales de otros tipos y los frmacos. Dos clasificaciones han sido usadas en la LMA: la primera, el Grupo Franco- Amrico-Britnico (FAB) y La segunda, publicada por la Organizacin Mundial de la Salud (OMS). El diagnstico de LMA es hecho cuando los blastos alcanzan el 20% en el aspirado de mdula sea. Los regmenes para induccin de la remisin completa que se usan con ms frecuencia consisten en una quimioterapia combinada de citarabina y una antraciclina. Conocer las caractersticas epidemiolgicas y respuesta a la terapia de induccin y remisin en los pacientes con leucemia mieloide aguda en el Hospital de Oncologa del Instituto Salvadoreo del Seguro Social desde enero 2011 a diciembre 2013 es el objetivo de este estudio. Se realiz un estudio observacional, descriptivo, transversal, basado en la aplicacin de un formulario a expedientes clnicos y resultados del laboratorio clnico de pacientes con diagnstico de Leucemia Mieloide Aguda entre enero 2011 a diciembre 2013 atendidos en el Hospital de Oncologa del Instituto Salvadoreo del Seguro Social. Los datos se analizaron usando Microsoft Excel 2010. Resultados: de 58 expedientes clnicos revisadas, 51 cumplieron criterios de inclusin. El 46.55% (27) fueron mujeres y el 53.45% (31) hombres. La media 2 de edad fue 52.15 aos. Segn la clasificacin FAB el subtipo ms frecuente fue M2, en un 27.59,5% (16/51). A los 51 pacientes se les realiz estudio inmunofentipico encontrando los siguientes marcadores ms frecuentes CD 117, CD 33, CD 13 y HLA DR. Durante la terapia de induccin presentaron remisin completa el 43.14% (22/51) y fallecieron 33.3% (17/51), siendo la causa de muerte ms frecuente la neumona en un 35.29% (6/17). Conclusin: En la poblacin atendida en el Hospital de Oncologa del ISSS encontramos que la LMA fue la neoplasia hematolgica ms frecuente con un pico de edad al diagnstico entres los 60 a 69 aos con mayor frecuencia en adultos de sexo masculino, la mayora de los cuales se presentaron con fiebre al diagnstico.
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La Leucemia Linfoblstica Aguda (LLA) es una enfermedad maligna caracterizada por la acumulacin de linfoblastos; diagnstico observado en el Hospital de Oncologa del Instituto Salvadoreo del Seguro Social (ISSS) sin tener hasta la fecha datos de su prevalencia y mortalidad dentro de la institucin. El inicio de la quimioterapia moderna y el progreso en las herramientas diagnsticas a contribuido a aumentar la sobrevida de los pacientes con LLA con un porcentaje en adultos del 30% al 40% a nivel mundial. Muchos de estos pacientes se catalogan en pacientes de riesgo estndar y pacientes de alto riesgo previo al inicio del tratamiento quimioteraputico basados en criterios clnicos y de laboratorio as como tambin inmunofenotipicos. El presente estudio ser conducido en el Instituto Salvadoreo del Seguro Social en pacientes con diagnstico nuevo de LLA en el periodo comprendido entre enero 2009 y diciembre 2013; haciendo una estudio observacional de cohorte retrospectivo, donde se comparar la eficacia teraputica de los dos tratamientos, esperando documentar los resultados en nuestra poblacin e identificar la frecuencia de recada, la sobrevida global, la sobrevida libre de progresin con solo tomar en cuenta la edad y valor de leucocitos al momento del diagnstico en aquellos catalogados con riesgo estndar que iniciaron tratamiento quimioteraputico convencional frente a aquellos que recibieron quimioterapia intensiva.
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La mucositis es una complicacin secundaria al tratamiento de quimioterapia intensiva que algunos pacientes con leucemia aguda puede presentar. Diferentes estudios internacionales han demostrado una alta incidencia de mucositis por lo que en el pas se hace necesario conocer la incidencia de dicha patologa en la poblacin peditrica. Objetivo: determinar la incidencia de mucositis asociada al tratamiento de quimioterapia en pacientes con Leucemia Mieloblstica Aguda y Leucemia Linfoblstica Aguda de alto riesgo, que ingresaron al departamento de oncologa del Hospital Nacional de Nios Benjamn Bloom de Enero 2008 a Diciembre 2012. Mtodo: se realiz una investigacin descriptiva de tipo retrospectivo de corte transversal, donde la poblacin total fue de 172 expedientes, de los cuales 35 de stos ya se encontraban depurados por ESDOMED, por lo que la poblacin en estudio fue de 137 pacientes, donde se describi la incidencia y tipo de mucositis, caractersticas clnicas y de laboratorio. Resultados: de la poblacin de 137 pacientes, 34 presentaron mucositis siendo la ms frecuente la estomatitis, el grado ms frecuente fue 2 y el nmero de episodios que se describi fue de 50, ya que el promedio de episodio fueron de 1.47, de stos casos el 74% present durante el episodio neutropenia. Conclusiones: los datos obtenidos en la investigacin son de importancia ya que no se cuenta con datos sobre mucositis en pacientes peditrico en el pas y cuyos resultados son acordes a la literatura mundial, lo cual ayuda a establecer las medidas a seguir para mejorar la calidad de vida de pacientes peditricos evitando as complicaciones.
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Coordenao de Aperfeioamento de Pessoal de Nvel Superior
