1
|
Cappellano A, Gorostegui M, Gonzalez-Ramella O, Filho NPC, Valencia D, Chantada L, Sampor C, Serrano MJ, Macedo C, Ramirez O, Sardinas S, Lezcano E, Calderón P, Gamboa Y, Fu L, Gómez W, Schelotto M, Ugaz C, Lobos P, Aguiar SDS, Moreno K, Palma J, Sánchez G, Moschella F, Gassant PYH, Velasquez T, Quintero K, Moreno F, Villarroel M, Fuentes Alabi S, Vasquez L, Challinor J, Chantada GL. International Society of Paediatric Oncology (SIOP) Global Mapping Programme: Latin American Society of Pediatric Oncology (SLAOP) country-level report. Pediatr Blood Cancer 2024; 71:e30973. [PMID: 38556746 DOI: 10.1002/pbc.30973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 02/27/2024] [Accepted: 03/08/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Latin American countries are improving childhood cancer care, showing strong commitment to implement the Global Initiative for Childhood Cancer, but there are scant publications of the situation at a continental level. METHODS As part of the International Society of Paediatric Oncology Global Mapping project, delegates of each country participating in the Latin American Society of Pediatric Oncology (SLAOP) and chairs of national pediatric oncology societies and cooperative groups were invited to provide information regarding availability of national pediatric cancer control programs (NPCCP), pediatric oncology laws, pediatric oncology tumor registries, and training programs and support to diagnosis and treatment. RESULTS Nineteen of the 20 countries participating in SLAOP responded. National delegates reported nine countries with NPCCP and four of them were launched in the past 5 years. National pediatric tumor registries are available in eight countries, and three provided published survival results. Fellowship programs for training pediatric oncologists are available in 12 countries. National delegates reported that eight countries provide support to most essential diagnosis and treatments and 11 provide partial or minimal support that is supplemented by civil society organizations. Seven countries have a pediatric oncology law. There are three international cooperative groups and four national societies for pediatric oncology. CONCLUSION Despite many challenges, there were dramatic advances in survivorship, access to treatment, and availability of NPCCP in Latin America. Countries with highest social development scores in general provide more complete support and are more likely to have NPCCP, training programs, and reported survival results.
Collapse
Affiliation(s)
| | - Maite Gorostegui
- Hospital Sant Joan de Déu, Pediatric Cancer Center Barcelona (PCCB), Barcelona, Spain
| | | | | | - Diana Valencia
- Department of Pediatric Oncology, IMAT Oncomedica AUNA, Monteria, Hospital Universitario de Santander, Bucaramanga, Colombia
| | | | | | | | - Carla Macedo
- Institute of Pediatric Oncology (IOP/GRAACC), São Paulo, Brazil
| | | | - Susan Sardinas
- Hospital del Niño Dr Ovidio Aliaga Uria, La Paz, Bolivia
| | - Eva Lezcano
- Hospital Central Del Instituto de Previsión Social (IPS), Asunción, Paraguay
| | | | - Yessika Gamboa
- Oncology Unit, National Children's Hospital, San José, Costa Rica
| | - Ligia Fu
- Hospital Escuela, Tegucigalpa, Honduras
| | - Wendy Gómez
- National Cancer Institute-INCART, Santo Domingo, Dominican Republic
| | | | - Cecilia Ugaz
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú
| | | | | | | | - Julia Palma
- Hospital Dr Luis Calvo Mackenna, Santiago, Chile
| | | | - Filomena Moschella
- Hospital Universitario Dr Luis Razetti, Barcelona Edo Anzoategui, Barcelona, Venezuela
| | | | - Thelma Velasquez
- Unidad Nacional de Oncologia Pediátrica (UNOP), Guatemala City, Guatemala
| | - Karina Quintero
- Children's Hospital Dr Jose Renan Esquivel, Panama City, Panama
| | | | | | - Soad Fuentes Alabi
- Hospital Nacional de Ninos Benjamin Bloom y Centro Medico Ayudame a Vivir, San Salvador, El Salvador
| | - Liliana Vasquez
- Department of Noncommunicable Diseases and Mental Health, Unit of Noncommunicable Diseases, Pan American Health Organization/World Health Organization, Washington, District of Columbia, USA
| | - Julia Challinor
- University of California San Francisco, San Francisco, California, USA
| | - Guillermo L Chantada
- Hospital Sant Joan de Déu, Pediatric Cancer Center Barcelona (PCCB), Barcelona, Spain
- Hospital Pereira Rosell Fundación Perez-Scremini, Montevideo, Uruguay
| |
Collapse
|
2
|
Silva RAM, de Mendonça RMH, Dos Santos Aguiar S, Yajima JC, Marson FAL, Brandalise SR, Levy CE. Induction therapy for acute lymphoblastic leukemia: incidence and risk factors for bloodstream infections. Support Care Cancer 2021; 30:695-702. [PMID: 34363492 DOI: 10.1007/s00520-021-06471-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 07/24/2021] [Indexed: 11/26/2022]
Abstract
Among the treatment-related acute toxic effects, risks for bloodstream infections (BSIs) are associated with several variables. The authors carried out a retrospective cohort study with 259 children and adolescents with ALL, treated with the GBTLI-LLA 2009 protocol, in order to assess the incidence of BSIs in the induction phase; to determine the risk factors for these BSIs; and to identify the related microorganisms and sensitivity profile of the microorganisms related to these infections. BSIs were documented in 19.3% of patients. The isolated microorganisms were 39 Gram-negative bacteria, 21 Gram-positive bacteria, and four fungi. There was a statistically significant risk of BSI between the variables: protocol for T-line-derived leukemia (Derived T Protocol) (p = 0.020), oral manifestations (p = 0.015), central venous catheter (p = 0.008), and bladder catheter (p = 0.004). BSI is a frequent event in ALL patients during the induction phase. The identification of these factors can allow the elaboration and improvement of strategies for the intensification of supportive care, prevention, and rapid treatment of infections.
Collapse
Affiliation(s)
- Rosângela Aparecida Mendes Silva
- Microbiology Laboratory, Centro Infantil Boldrini, Rua Gabriel Porto, 1270, Campinas, SP, 13083-210, Brazil.
- Pediatric Research Center, Campinas, State University of Campinas, Campinas, SP, Brazil.
| | - Regina Maria Holanda de Mendonça
- Pediatric Research Center, Campinas, State University of Campinas, Campinas, SP, Brazil
- Dentistry Unit, Centro Infantil Boldrini, Campinas, SP, Brazil
| | | | | | | | | | - Carlos Emílio Levy
- Department of Clinical Pathology, State University of Campinas, Campinas, SP, Brazil
| |
Collapse
|
3
|
Almendra Mattos RM, de Mendonça RMH, Dos Santos Aguiar S. Adherence to dental treatment reduces oral complications related to cancer treatment in pediatric and adolescent patients. Support Care Cancer 2019; 28:661-670. [PMID: 31123869 DOI: 10.1007/s00520-019-04857-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 05/09/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To analyze the association between adherence to dental treatment and (1) oral complications and (2) clinical and sociodemographic aspects of pediatric and adolescent patients with cancer. METHODS A retrospective cohort study with a sample of 147 children and adolescents who underwent cancer treatment of solid tumors or lymphomas was carried out. The patients were divided into three groups according to previously established criteria. Sociodemographic aspects and oncological, dental, and oral complications were analyzed. RESULTS The mean age of patients was 6.7 ± 6.09 years; 57.1% were males and 42.9% were females. Of the 147 patients, 37.41% had full adherence, 33.3% had partial adherence, and 29.3% had non-adherence to the proposed dental treatment. A statistically significant association between oral complications and adherence to dental treatment (p = 0.006) could be observed. The presence of caries lesions at the initial oral examination presented a statistically significant association with adherence to dental treatment (p = 0.004). Children with caries lesions at the initial dental examination had an 88% higher risk of developing oral complications compared with those without caries (RR = 1.88, 95% CI 1.01-3.49). After adjustments for age and the presence of caries lesions at the initial examination, adherence to dental treatment remained the only independent risk factor for oral complications (adjusted RR = 2.56, 95% CI 1.17-5.57). CONCLUSIONS This study has demonstrated that non-adherence to dental treatment was associated with higher incidence of oral complications and it is a risk factor for these complications. The presence of caries lesions at the initial oral examination was associated with non-adherence to dental treatment.
Collapse
Affiliation(s)
- Rafaela Maia Almendra Mattos
- Centro de Investigação em Pediatria (CIPED), Universidade Estadual de Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126 - Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-887, Brazil.
| | - Regina Maria Holanda de Mendonça
- Centro de Investigação em Pediatria (CIPED), Universidade Estadual de Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126 - Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-887, Brazil.,Departamento de Odontologia, Centro Infantil Boldrini, Campinas, SP, Brazil
| | - Simone Dos Santos Aguiar
- Centro de Investigação em Pediatria (CIPED), Universidade Estadual de Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126 - Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-887, Brazil
| |
Collapse
|
4
|
Gilli IO, Joaquim AF, Tedeschi H, Dos Santos Aguiar S, Morcillo AM, Ghizoni E. Factors affecting diagnosis of primary pediatric central nervous system neoplasias in a developing country. Childs Nerv Syst 2019; 35:91-96. [PMID: 30250987 DOI: 10.1007/s00381-018-3958-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 08/19/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Understand the variables that could interfere with diagnosis and prompt treatment in CNS childhood cancer in Brazil, a developing country with continental dimensions. METHODS From 2005 to 2010, we retrospectively evaluated factors, which could represent a negative influence on the time period elapsing from the onset of symptoms until the diagnosis of the central nervous system (CNS) neoplasia in children and adolescents attended in our service. RESULTS Two hundred seventeen records were analyzed retrospectively. Factors of the households were evaluated, and this data was related to the time period elapsing from presentation of the first symptoms until the diagnosis of CNS neoplasia. The average time elapsed from the onset of the symptoms until seeking medical assistance was 96 days, and from medical assistance to patient referral to a reference service was 33 days. The symptoms which most contributed to a shorter delay in diagnosis were changes in gait and paresis, mother's occupation, father's education level, patient gender, and living in the state of São Paulo. Besides that, variables such as male gender, mother's education level, and lower patient age were associated with an early diagnosis time. CONCLUSION There is great difficulty in performing early diagnosis of CNS tumors, partly due to parent's inability to recognize signs and symptoms, and in part due to an educational deficit among healthcare professionals. Identification of measures that can minimize these causes of delay is fundamental to increasing the chance of cure and survival of these patients.
Collapse
Affiliation(s)
- Isadora Olenscki Gilli
- Childhood Hematological Investigations Center Dr. Domingos A. Boldrini., Dr. Gabriel Porto St., 1270 Cidade Universitária, Campinas, SP, 13083-210, Brazil.
| | - Andrei Fernandes Joaquim
- Division of Neurosurgery, Department of Neurology, University of Campinas, Tessalia Vieira de Camargo St., 126, Campinas, SP, 13083-887, Brazil
| | - Helder Tedeschi
- Childhood Hematological Investigations Center Dr. Domingos A. Boldrini., Dr. Gabriel Porto St., 1270 Cidade Universitária, Campinas, SP, 13083-210, Brazil.,Division of Neurosurgery, Department of Neurology, University of Campinas, Tessalia Vieira de Camargo St., 126, Campinas, SP, 13083-887, Brazil
| | - Simone Dos Santos Aguiar
- Center for Investigation in Pediatrics (CIPED), University of Campinas, Tessalia Vieira de Camargo St., 126, Campinas, SP, 13083-887, Brazil
| | - Andre Moreno Morcillo
- Center for Investigation in Pediatrics (CIPED), University of Campinas, Tessalia Vieira de Camargo St., 126, Campinas, SP, 13083-887, Brazil.,Department of Pediatrics, University of Campinas, Tessalia Vieira de Camargo St., 126, Campinas, SP, 13083-887, Brazil
| | - Enrico Ghizoni
- Childhood Hematological Investigations Center Dr. Domingos A. Boldrini., Dr. Gabriel Porto St., 1270 Cidade Universitária, Campinas, SP, 13083-210, Brazil.,Division of Neurosurgery, Department of Neurology, University of Campinas, Tessalia Vieira de Camargo St., 126, Campinas, SP, 13083-887, Brazil
| |
Collapse
|
5
|
Bezerra Salomão K, Cruzeiro GAV, Bonfim-Silva R, Geron L, Ramalho F, Pinto Saggioro F, Serafini LN, Antunes Moreno D, de Paula Queiroz RG, Dos Santos Aguiar S, Cardinalli I, Yunes JA, Brandalise SR, Brassesco MS, Scrideli CA, Gonzaga Tone L. Reduced hydroxymethylation characterizes medulloblastoma while TET and IDH genes are differentially expressed within molecular subgroups. J Neurooncol 2018; 139:33-42. [PMID: 29582271 DOI: 10.1007/s11060-018-2845-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/17/2018] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Medulloblastoma (MB) is an embryonal tumour that originates from genetic deregulation of cerebellar developmental pathways and is classified into 4 molecular subgroups: SHH, WNT, group 3, and group 4. Hydroxymethylation levels progressively increases during cerebellum development suggesting a possibility of deregulation in MB pathogenesis. The aim of this study was to investigate global hydroxymethylation levels and changes in TET and IDH gene expression in MB samples compared to control cerebellum samples. METHODS The methods utilized were qRT-PCR for gene expression, dot-blot and immunohistochemistry for global hydroxymethylation levels and sequencing for the investigation of IDH mutations. RESULTS Our results show that global hydroxymethylation level was decreased in MB, and low 5hmC level was associated with the presence of metastasis. TET1 expression levels were decreased in the WNT subgroup, while TET3 expression levels were decreased in the SHH subgroup. Reduced TET3 expression levels were associated with the presence of events such as relapse and death. Higher expression of IDH1 was observed in MB group 3 samples, whereas no mutations were detected in exon 4 of IDH1 and IDH2. CONCLUSION These findings suggest that reduction of global hydroxymethylation levels, an epigenetic event, may be important for MB development and/or maintenance, representing a possible target in this tumour and indicating a possible interaction of TET and IDH genes with the developmental pathways specifically activated in the MB subgroups. These genes could be specific targets and markers for each subgroup.
Collapse
Affiliation(s)
- Karina Bezerra Salomão
- Department of Paediatrics, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil. .,Department of Genetics, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil. .,Ribeirão Preto School of Medicine, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil.
| | - Gustavo Alencastro Veiga Cruzeiro
- Department of Paediatrics, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil.,Department of Genetics, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil.,Ribeirão Preto School of Medicine, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil
| | - Ricardo Bonfim-Silva
- Department of Genetics, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil.,Ribeirão Preto School of Medicine, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil
| | - Lenisa Geron
- Department of Paediatrics, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil.,Department of Genetics, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil.,Ribeirão Preto School of Medicine, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil
| | - Fernando Ramalho
- Department of Pathology, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil.,Ribeirão Preto School of Medicine, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil
| | - Fabiano Pinto Saggioro
- Department of Pathology, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil.,Ribeirão Preto School of Medicine, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil
| | - Luciano Neder Serafini
- Department of Pathology, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil.,Ribeirão Preto School of Medicine, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil
| | - Daniel Antunes Moreno
- Department of Genetics, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil.,Ribeirão Preto School of Medicine, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil
| | - Rosane Gomes de Paula Queiroz
- Department of Paediatrics, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil.,Department of Genetics, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil.,Ribeirão Preto School of Medicine, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil
| | | | - Izilda Cardinalli
- Boldrini Centre of Children, University of Campinas-UNICAMP, Campinas, SP, Brazil
| | - José Andres Yunes
- Boldrini Centre of Children, University of Campinas-UNICAMP, Campinas, SP, Brazil
| | | | - Maria Sol Brassesco
- Ribeirão Preto School of Medicine, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil.,Faculty of Philosophy, Sciences and Letters at Ribeirão Preto, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil
| | - Carlos Alberto Scrideli
- Department of Paediatrics, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil.,Department of Genetics, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil.,Ribeirão Preto School of Medicine, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil
| | - Luiz Gonzaga Tone
- Department of Paediatrics, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil.,Department of Genetics, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil.,Ribeirão Preto School of Medicine, University of São Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, SP, 14049-900, Brazil
| |
Collapse
|
6
|
Andrade AF, Borges KS, Suazo VK, Geron L, Corrêa CAP, Castro-Gamero AM, de Vasconcelos EJR, de Oliveira RS, Neder L, Yunes JA, Aguiar SDS, Scrideli CA, Tone LG. Erratum to: The DNA methyltransferase inhibitor zebularine exerts antitumor effects and reveals BATF2 as a poor prognostic marker for childhood medulloblastoma. Invest New Drugs 2016; 35:124. [PMID: 27900530 DOI: 10.1007/s10637-016-0412-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Augusto Faria Andrade
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo (USP), Avenida Bandeirantes 3900, 14048-900, Ribeirão Preto, SP, Brazil. .,Departamento de Genética, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Avenida Bandeirantes 3900, 14048-900, Ribeirão Preto, SP, Brazil.
| | - Kleiton Silva Borges
- Department of Pediatrics - Ribeirão Preto Medical School, University of São Paulo (USP), São Paulo, Brazil
| | - Veridiana Kiill Suazo
- Department of Pediatrics - Ribeirão Preto Medical School, University of São Paulo (USP), São Paulo, Brazil
| | - Lenisa Geron
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo (USP), Avenida Bandeirantes 3900, 14048-900, Ribeirão Preto, SP, Brazil
| | | | | | | | | | - Luciano Neder
- Department of Pathology, Ribeirão Preto Medical School, USP, São Paulo, Brazil
| | | | | | - Carlos Alberto Scrideli
- Department of Pediatrics - Ribeirão Preto Medical School, University of São Paulo (USP), São Paulo, Brazil
| | - Luiz Gonzaga Tone
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo (USP), Avenida Bandeirantes 3900, 14048-900, Ribeirão Preto, SP, Brazil.,Department of Pediatrics - Ribeirão Preto Medical School, University of São Paulo (USP), São Paulo, Brazil
| |
Collapse
|
7
|
Andrade AF, Borges KS, Suazo VK, Geron L, Corrêa CAP, Castro-Gamero AM, de Vasconcelos EJR, de Oliveira RS, Neder L, Yunes JA, Dos Santos Aguiar S, Scrideli CA, Tone LG. The DNA methyltransferase inhibitor zebularine exerts antitumor effects and reveals BATF2 as a poor prognostic marker for childhood medulloblastoma. Invest New Drugs 2016; 35:26-36. [PMID: 27785591 DOI: 10.1007/s10637-016-0401-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 10/20/2016] [Indexed: 12/11/2022]
Abstract
Medulloblastoma (MB) is the most common solid tumor among pediatric patients and corresponds to 20 % of all pediatric intracranial tumors in this age group. Its treatment currently involves significant side effects. Epigenetic changes such as DNA methylation may contribute to its development and progression. DNA methyltransferase (DNMT) inhibitors have shown promising anticancer effects. The agent Zebularine acts as an inhibitor of DNA methylation and shows low toxicity and high efficacy, being a promising adjuvant agent for anti-cancer chemotherapy. Several studies have reported its effects on different types of tumors; however, there are no studies reporting its effects on MB. We analyzed its potential anticancer effects in four pediatric MB cell lines. The treatment inhibited proliferation and clonogenicity, increased the apoptosis rate and the number of cells in the S phase (p < 0.05), as well as the expression of p53, p21, and Bax, and decreased cyclin A, Survivin and Bcl-2 proteins. In addition, the combination of zebularine with the chemotherapeutic agents vincristine and cisplatin resulted in synergism and antagonism, respectively. Zebularine also modulated the activation of the SHH pathway, reducing SMO and GLI1 levels and one of its targets, PTCH1, without changing SUFU levels. A microarray analysis revealed different pathways modulated by the drug, including the Toll-Like Receptor pathway and high levels of the BATF2 gene. The low expression of this gene was associated with a worse prognosis in MB. Taken together, these data suggest that Zebularine may be a potential drug for further in vivo studies of MB treatment.
Collapse
Affiliation(s)
- Augusto Faria Andrade
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo (USP), Avenida Bandeirantes 3900, 14048-900, Ribeirão Preto, SP, Brazil.
| | - Kleiton Silva Borges
- Department of Pediatrics - Ribeirão Preto Medical School, University of São Paulo (USP), São Paulo, Brazil
| | - Veridiana Kiill Suazo
- Department of Pediatrics - Ribeirão Preto Medical School, University of São Paulo (USP), São Paulo, Brazil
| | - Lenisa Geron
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo (USP), Avenida Bandeirantes 3900, 14048-900, Ribeirão Preto, SP, Brazil
| | | | | | | | | | - Luciano Neder
- Department of Pathology, Ribeirão Preto Medical School, USP, São Paulo, Brazil
| | | | | | - Carlos Alberto Scrideli
- Department of Pediatrics - Ribeirão Preto Medical School, University of São Paulo (USP), São Paulo, Brazil
| | - Luiz Gonzaga Tone
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo (USP), Avenida Bandeirantes 3900, 14048-900, Ribeirão Preto, SP, Brazil.,Department of Pediatrics - Ribeirão Preto Medical School, University of São Paulo (USP), São Paulo, Brazil
| |
Collapse
|
8
|
Lopes LF, Macedo CRPD, Aguiar SDS, Barreto JHS, Martins GE, Sonaglio V, Milone M, Lima ER, Almeida MTDA, Lopes PMAA, Watanabe FM, D'Andrea MLM, Pianovski MA, Melaragno R, Vianna SMR, Moreira MES, Bruniera P, de Oliveira CZ. Lowered Cisplatin Dose and No Bleomycin in the Treatment of Pediatric Germ Cell Tumors: Results of the GCT-99 Protocol From the Brazilian Germ Cell Pediatric Oncology Cooperative Group. J Clin Oncol 2016; 34:603-10. [PMID: 26729441 DOI: 10.1200/jco.2014.59.1420] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE We describe the results of a risk-adapted, response-based therapeutic approach from the Brazilian GCT-99 study on germ cell tumors. PATIENTS AND METHODS From May 1999 to October 2009, 579 participants were enrolled in the Brazilian GCT-99 study. Treatment, defined as specific chemotherapy regimen and number of cycles, was allocated by means of risk-group assignment at diagnosis with consideration for stage and primary tumor site. Patients at low risk received no chemotherapy. Patients at intermediate risk (IR) with a good response (GR) received four cycles of platinum and etoposide (PE), for total doses of platinum 420 mg/m(2) and etoposide 2,040 mg/m(2). Patients at IR with a partial response (PR) received three cycles of PE plus three cycles of ifosfamide, vinblastine, and bleomycin. Patients at high risk (HR) with a GR received four cycles of PE and ifosfamide (PEI) at total doses of platinum 420 mg/m(2), etoposide 1,200 mg/m(2), and ifosfamide 30 g/m(2). Patients at HR with a PR received six cycles of PEI. RESULTS The risk-group distribution was 213 LR, 138 IR, and 129 HR for 480 evaluable patients. Overall survival (OS) and event-free survival (EFS) rates at 10 years were, respectively, 90% and 88.6% in the IR-GR group (n = 126) and 74.1% and 74.1% in the IR-PR group (n = 12). Ten-year rates for the HR-GR group (n = 86) were an OS of 66.8% and an EFS of 62.5%. The HR-PR group (n = 43) had an OS of 74.8% and an EFS of 73.4%. In univariable and multivariable analysis, increased serum lactate dehydrogenase level and histology for a metastatic immature teratoma were prognostic of a worsened outcome. CONCLUSION Reduction of therapy to two drugs did not compromise survival outcomes for patients in the IR-GR group, and escalation of therapy with PEI did not significantly improve OS and EFS in patients at HR.
Collapse
Affiliation(s)
- Luiz Fernando Lopes
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil.
| | - Carla Renata Pacheco Donato Macedo
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Simone Dos Santos Aguiar
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Jose Henrique S Barreto
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Gisele Eiras Martins
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Viviane Sonaglio
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Marcelo Milone
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Eduardo Ribeiro Lima
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Maria Teresa de Assis Almeida
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Paula Maria Azevedo Allemand Lopes
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Flora Mitie Watanabe
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Maria Lydia Mello D'Andrea
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Mara Albonei Pianovski
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Renato Melaragno
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Sonia Maria Rossi Vianna
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Mauber Eduardo Schultz Moreira
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Paula Bruniera
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Cleyton Zanardo de Oliveira
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| |
Collapse
|
9
|
Eid KADB, Miranda ECM, Aguiar SDS. Mobilization and collection of CD34(+) cells for autologous transplantation of peripheral blood hematopoietic progenitor cells in children: analysis of two different granulocyte-colony stimulating factor doses. Rev Bras Hematol Hemoter 2015; 37:160-6. [PMID: 26041417 PMCID: PMC4459484 DOI: 10.1016/j.bjhh.2015.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 09/15/2014] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The use of peripheral hematopoietic progenitor cells (HPCs) is the cell choice in autologous transplantation. The classic dose of granulocyte-colony stimulating factor (G-CSF) for mobilization is a single daily dose of 10μg/kg of patient body weight. There is a theory that higher doses of granulocyte-colony stimulating factor applied twice daily could increase the number of CD34(+) cells collected in fewer leukapheresis procedures. OBJECTIVE The aim of this study was to compare a fractionated dose of 15μg G-CSF/kg of body weight and the conventional dose of granulocyte-colony stimulating factor in respect to the number of leukapheresis procedures required to achieve a minimum collection of 3×10(6) CD34(+) cells/kg body weight. METHODS Patients were divided into two groups: Group 10 - patients who received a single daily dose of 10μg G-CSF/kg body weight and Group 15 - patients who received a fractioned dose of 15μg G-CSF/kg body weight daily. The leukapheresis procedure was carried out in an automated cell separator. The autologous transplantation was carried out when a minimum number of 3×10(6) CD34(+) cells/kg body weight was achieved. RESULTS Group 10 comprised 39 patients and Group 15 comprised 26 patients. A total of 146 apheresis procedures were performed: 110 (75.3%) for Group 10 and 36 (24.7%) for Group 15. For Group 10, a median of three (range: 1-7) leukapheresis procedures and a mean of 8.89×10(6) CD34(+) cells/kg body weight (±9.59) were collected whereas for Group 15 the corresponding values were one (range: 1-3) and 5.29×10(6) cells/kg body weight (±4.95). A statistically significant difference was found in relation to the number of apheresis procedures (p-value <0.0001). CONCLUSIONS To collect a minimum target of 3×10(6) CD34(+) cells/kg body weight, the administration of a fractionated dose of 15μg G-CSF/kg body weight significantly decreased the number of leukapheresis procedures performed.
Collapse
Affiliation(s)
- Kátia Aparecida de Brito Eid
- Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil; Centro Infantil Boldrini, Campinas, SP, Brazil.
| | | | - Simone Dos Santos Aguiar
- Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil; Centro Infantil Boldrini, Campinas, SP, Brazil
| |
Collapse
|
10
|
Petrilli AS, Macedo CR, Ferman S, Scopinaro M, Cacciavillano W, Boldrini E, Morais VLL, Rey GL, de Oliveira CT, Castillo LA, Almeida MTA, Borsato ML, Lima E, Lustosa D, Barreto JH, Brunetto AL, Costa TELJAICKB, Dos Santos Aguiar S, Petrilli M, Alves MTDS. Results of a randomized prospective clinical trial evaluating maintenance chemotherapy in patients with high-grade, operable osteosarcoma: A report from the Latin American Group of Osteosarcoma Treatment. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.10532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Carla R. Macedo
- Instituto de Oncologia Pediatrica IOP/GRAACC - UNIFESP, Sao Paulo, Brazil
| | - Sima Ferman
- Instituto Nacional do Cancer (INCA), Rio de Janeiro, Brazil
| | - Marcelo Scopinaro
- Hospital de Pediatria S.A.M.I.C. - Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | | | - Erica Boldrini
- Hospital de Cancer Barretos - Fundacao Pio XII, Barretos, Brazil
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Lucon DR, Rocha CDS, Craveiro RB, Dilloo D, Cardinalli IA, Cavalcanti DP, Aguiar SDS, Maurer-Morelli C, Yunes JA. Downregulation of 14q32 microRNAs in Primary Human Desmoplastic Medulloblastoma. Front Oncol 2013; 3:254. [PMID: 24093088 PMCID: PMC3782711 DOI: 10.3389/fonc.2013.00254] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 09/10/2013] [Indexed: 11/17/2022] Open
Abstract
Medulloblastoma (MB) is one of the most common pediatric cancers, likely originating from abnormal development of cerebellar progenitor neurons. MicroRNA (miRNA) has been shown to play an important role in the development of the central nervous system. Microarray analysis was used to investigate miRNA expression in desmoplastic MB from patients diagnosed at a young age (1 or 2 years old). Normal fetal or newborn cerebellum was used as control. A total of 84 differentially expressed miRNAs (64 downregulated and 20 upregulated) were found. Most downregulated miRNAs (32/64) were found to belong to the cluster of miRNAs at the 14q32 locus, suggesting that this miRNA locus is regulated as a module in MB. Possible mechanisms of 14q32 miRNAs downregulation were investigated by the analysis of publicly available gene expression data sets. First, expression of estrogen-related receptor-γ (ESRRG), a reported positive transcriptional regulator of some 14q32 miRNAs, was found downregulated in desmoplastic MB. Second, expression of the parentally imprinted gene MEG3 was lower in MB in comparison to normal cerebellum, suggesting a possible epigenetic silencing of the 14q32 locus. miR-129-5p (11p11.2/7q32.1), miR-206 (6p12.2), and miR-323-3p (14q32.2), were chosen for functional studies in DAOY cells. Overexpression of miR-129-5p using mimics decreased DAOY proliferation. No effect was found with miR-206 or miR-323 mimics.
Collapse
Affiliation(s)
- Danielle Ribeiro Lucon
- Centro Infantil Boldrini , Campinas , Brazil ; Departamento de Genética Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas , Campinas , Brazil
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Abstract
Advanced disease is a risk factor for eye loss in patients with retinoblastoma (RB). We still record critical rates of enucleation, especially for unilateral RB due to advanced stages of disease at diagnosis. This retrospective study of 223 RB patient records referred to treatment at Centro Infantil Boldrini, Brazil, between 1978 and 2008, showed that 176 patients (79%) presented intraocular tumors while 47 (21%) already had extraocular involvement. At the time of diagnosis, the age of patients was 26.2 months in the group that had enucleated eyes and 13.7 months in the group that preserved both eyes. Under a multiple logistic regression model, familial history (OR = 0.195; p = .01) and age at diagnosis in months (OR = 1.047; p = .04) were significantly correlated with enucleation. Strategies to early detect RB must be changed in order to offer better chances of ocular preservation with visual function. Authors propose a systematic referral of all children to the ophthalmologist for an indirect ophthalmoscopy once a year in the first two years of life, as a measure to be adopted by all pediatricians in daily routine to early detect the tumor.
Collapse
Affiliation(s)
- Maristela A Palazzi
- Pediatric Oncology/Ophthalmology, Centro Infantil Boldrini, Campinas, Sao Paulo, Brazil.
| | | | | | | |
Collapse
|
13
|
Seidinger AL, Mastellaro MJ, Paschoal Fortes F, Godoy Assumpção J, Aparecida Cardinalli I, Aparecida Ganazza M, Correa Ribeiro R, Brandalise SR, Dos Santos Aguiar S, Yunes JA. Association of the highly prevalent TP53 R337H mutation with pediatric choroid plexus carcinoma and osteosarcoma in southeast Brazil. Cancer 2010; 117:2228-35. [PMID: 21192060 DOI: 10.1002/cncr.25826] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 11/08/2010] [Accepted: 11/09/2010] [Indexed: 11/11/2022]
Abstract
BACKGROUND The inherited, low-penetrance arginine-to-histidine substitution at codon 337 (R337H) of the tumor protein 53 gene (TP53) is clustered in southeast Brazil (estimated frequency, 0.3%). Although its tumorigenic effect initially appeared to be tissue-specific, recent evidence suggests its association with a broader range of tumors. Therefore, the authors of this report investigated the spectrum of pediatric malignancies associated with the TP53 R337H mutation at a single referral institution in southeast Brazil. METHODS Genomic DNA samples from 493 children with malignancies were screened for the R337H mutation. Available tumor samples from carriers were investigated for loss of heterozygosity (LOH) and nuclear p53 accumulation. Clinical data were obtained from medical records. RESULTS Sixty-five of 70 patients (93%) with adrenocortical tumors (ACTs), 9 of 13 patients (69%) with choroid plexus carcinoma (CPC), and 3 of 41 patients (7.3%) with osteosarcoma carried the mutation. The proportion of CPC to choroid plexus papilloma (CPP) was much higher than that reported elsewhere. Osteosarcoma in carriers had a significantly poorer outcome (P = .02). The mutation was not identified in patients who had acute lymphoblastic leukemia (ALL) (n = 187), recurrent ALL (n = 49), acute myeloid leukemia (n = 44), lymphoma (n = 30), non-CPC central nervous system tumors (n = 26), Ewing sarcoma (n = 25), or rhabdomyosarcoma (n = 8). Among the tumors that were available for analysis, LOH with retention of the mutant allele was confirmed in 21 of 21 ACTs, in 2 of 2 CPCs, and in 2 of 3 osteosarcomas that were positive for R337H. CPCs and osteosarcomas that were positive for R337H had marked nuclear accumulation of p53. CONCLUSIONS The current findings demonstrated compellingly that the TP53 R337H mutation is associated not only with ACT but also with CPC and, to a lesser extent, with osteosarcoma, both of which are core-component tumors of the Li-Fraumeni syndrome.
Collapse
Affiliation(s)
- Ana Luiza Seidinger
- Molecular Biology Laboratory, Boldrini Children's Center, Campinas, Sao Paulo, Brazil
| | | | | | | | | | | | | | | | | | | |
Collapse
|