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Lobo C, Araújo A, Antunes ADA, Pinto ACS, Godinho AC, Pires CSM, Matheus CC, Albuquerque XD, Neves DCF, Moreno FDL, Baldanzi G, Siufi GC, Miranda HHP, Hankins J, Aragão J, Braga JAP, Martins JTN, Souza LCCMD, Figueiredo MS, Oliveira MR, Cardoso PSR, Pinto PCA, Moura PG, Cançado RD, Araujo PICD, Saad SO, Loggetto SR, Fonseca TCC. Consensus of the Brazilian Association of Hematology, Hemotherapy and Cellular Therapy (ABHH) and the Brazilian Ministry of Health - General management of blood and blood products on the tests necessary for the release of exceptional medicines for sickle cell disease. Hematol Transfus Cell Ther 2024; 46:67-71. [PMID: 38326179 PMCID: PMC10935471 DOI: 10.1016/j.htct.2024.01.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 02/09/2024] Open
Abstract
To date, hydroxyurea is the only effective and safe drug that significantly reduces morbidity and mortality of individuals with Sickle cell disease. Twenty years of real-life experience has demonstrated that hydroxyurea reduces pain attacks, vaso-occlusive events, including acute chest syndrome, the number and duration of hospitalizations and the need for transfusion. The therapeutic success of hydroxyurea is directly linked to access to the drug, the dose used and adherence to treatment which, in part, is correlated to the availability of hydroxyurea. This consensus aims to reduce the number of mandatory exams needed to access the drug, prioritizing the requesting physician's report, without affecting patient safety.
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Affiliation(s)
- Clarisse Lobo
- Hemocentro Coordenador do Estado do Rio de Janeiro (HEMORIO), Rio de Janeiro, RJ, Brazil.
| | - Aderson Araújo
- Fundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE) Recife, PE, Brazil
| | | | | | | | | | | | - Xerez de Albuquerque
- Fundação de Hematologia e Hemoterapia do Amazonas, Secretaria de Saúde do Amazonas, Manaus, AM, Brazil
| | | | | | - Giorgio Baldanzi
- Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, PR, Brazil
| | | | | | - Jane Hankins
- St. Jude Children's Research Hospital, Menphis, TN, USA
| | - Joice Aragão
- Coordenação Geral de Sangue e Hemoderivados do Ministério da Saúde, Brasilia, DF, Brazil
| | | | | | | | | | | | | | | | - Patricia Gomes Moura
- Hemocentro Coordenador do Estado do Rio de Janeiro (HEMORIO), Rio de Janeiro, RJ, Brazil
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Correa BT, Silva GSS, Mendes WJS, Maia ADM, Aleluia ACM, Fonseca TCC, da Guarda CC, Gonçalves MDS, Aleluia MM. Association of the clinical profile and overall survival of pediatric patients with acute lymphoblastic leukemia. Front Pediatr 2023; 11:1223889. [PMID: 37744444 PMCID: PMC10513176 DOI: 10.3389/fped.2023.1223889] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/25/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction The clarification of etiopathology, the improvement of chemotherapy regimens and their risk stratifications, and the improvement in treatment support have increased the survival of children and adolescents affected by Acute Lymphoblastic Leukemia (ALL) past few years. This study aimed to estimate overall survival (OS) and event-free survival (EFS) in an onco-hematology treatment center in Brazil, reports the main clinical-laboratory characteristics of patients at diagnosis, verify the frequency of treatment-related adverse effects and the main causes of death. Material and methods Retrospective analysis involving patients diagnosed with ALL, treated with the protocol of the Brazilian Group for Treatment of Leukemias in Childhood (GBTLI), between 2010 and 2020 was carried out; the outcomes (relapse, deaths, development of new neoplasms) were analyzed SPSS® software was used for the statistical analyses, and the p-value was considered significant when less than 0.05 for all analyses. Results 109 patients were included in the study; the median age was 5 years, with a slight predominance of males. Sixty-six patients were classified as high-risk (HR) group and 43 patients were classified as low-risk (LR) group. After 5 years of diagnosis, the OS was 71.5%, and the EFS was 65%. No statistical difference was found between the HR and LR groups for OS and EFS, while leukocyte counts were statistically associated with the outcome of death (p = 0.028). Among the patients, 28 (25.6%) died due to infection accounting 46.4% of death causes. Among the 34 patients with unfavorable outcomes (death and/or relapse), 32 had no research for the minimal residual disease at the end of remission induction, and 25 were not investigated for the presence of chromosomal abnormalities. The most reported complications and treatment-related adverse effects were increased liver transaminases (85.9%), airway infection (79.4%), oral mucositis (67.2%), febrile neutropenia (64.4%), and diarrhea (36.4%). Conclusions The rates of OS and EFS obtained in this cohort are similar to those obtained in the few previous similar studies in Brazil and lower than those carried out in developed countries. The unavailability of prognostic tests may have hindered risk stratification and influenced the results obtained.
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Affiliation(s)
- Bruno Terra Correa
- Departamento de Ciências Biológicas, Laboratório de Patologia Aplicada e Genética, Universidade Estadual de Santa Cruz, Ilhéus, Bahia, Brasil
| | - Gabriela Sales Serra Silva
- Departamento de Ciências Biológicas, Laboratório de Patologia Aplicada e Genética, Universidade Estadual de Santa Cruz, Ilhéus, Bahia, Brasil
| | - Webert Joaquim Silva Mendes
- Departamento de Ciências Biológicas, Laboratório de Patologia Aplicada e Genética, Universidade Estadual de Santa Cruz, Ilhéus, Bahia, Brasil
| | | | - Augusto Cezar Magalhães Aleluia
- Departamento de Ciências Naturais, Universidade Estadual do Sudoeste da Bahia-Campus de Vitória da Conquista, Vitória da Conquista, Bahia, Brasil
| | | | - Caroline Conceição da Guarda
- Departamento de Ciências Biológicas, Laboratório de Patologia Aplicada e Genética, Universidade Estadual de Santa Cruz, Ilhéus, Bahia, Brasil
| | - Marilda de Souza Gonçalves
- Laboratório de Investigação Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brasil
| | - Milena Magalhães Aleluia
- Departamento de Ciências Biológicas, Laboratório de Patologia Aplicada e Genética, Universidade Estadual de Santa Cruz, Ilhéus, Bahia, Brasil
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Suarez-Kurtz G, Almeida CW, Chapchap E, Schramm MT, Ikoma-Coltutato MRV, Lins MM, Fonseca TCC, Aguiar TF, Emerenciano M. Pharmacogenetic testing for thiopurine drugs in Brazilian acute lymphoblastic leukemia patients. Clinics (Sao Paulo) 2023; 78:100214. [PMID: 37156205 DOI: 10.1016/j.clinsp.2023.100214] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/25/2023] [Indexed: 05/10/2023] Open
Affiliation(s)
- Guilherme Suarez-Kurtz
- Divisão de Pesquisa Clínica e Desenvolvimento Tecnológico, Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brazil.
| | - Cristina Wiggers Almeida
- Hospital Federal da Lagoa (HFL), Rio de Janeiro, RJ, Brazil; Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | | | - Márcia Trindade Schramm
- Hospital do Câncer I, Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brazil; Prontobaby Hospital da Criança Ltda, Rio de Janeiro, RJ, Brazil
| | | | | | | | - Thais Ferraz Aguiar
- Instituto Estadual de Hematologia Arthur Siqueira Cavalcanti, Rio de Janeiro, RJ, Brazil
| | - Mariana Emerenciano
- Divisão de Pesquisa Básica e Experimental, Instituto Nacional de Câncer Rio de Janeiro, RJ, Brazil
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Santos EDC, Santana PVB, de Jesus LLS, Melo GIV, Yahouédéhou SCMA, da Guarda CC, Santiago RP, Fiuza LM, Carvalho SP, dos Santos LO, Adorno EV, Aleluia ACM, Luiz LCGC, Fonseca TCC, Gonçalves MDS, Aleluia MM. Leg Ulcers in Sickle Cell Disease: A Multifactorial Analysis Highlights the Hemolytic Profile. Hematol Rep 2023; 15:119-129. [PMID: 36810556 PMCID: PMC9945128 DOI: 10.3390/hematolrep15010013] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/12/2023] [Accepted: 02/02/2023] [Indexed: 02/17/2023] Open
Abstract
Sickle cell disease (SCD) is characterized by the presence of the variant S hemoglobin (HbS). The homozygous genotype (HbSS) is sickle cell anemia (SCA), while the double heterozygous of HbS and HbC (HbSC) is defined as SC hemoglobinopathy. The pathophysiology is based on chronic hemolysis, inflammation, endothelial dysfunction, and vaso-occlusion, which results in vasculopathy and serious clinical manifestations. Sickle leg ulcers (SLUs) are cutaneous lesions around the malleoli frequent in 20% of Brazilian patients with SCD. SLUs present a variable clinical and laboratory pattern modulated by several characteristics that are not fully understood. Hence, this study aimed to investigate laboratory biomarkers and genetic and clinical parameters associated with the development of SLUs. This descriptive cross-sectional study included 69 SCD patients, 52 without SLU (SLU-) and 17 with active or previous SLU history (SLU+). The results showed a higher incidence of SLU in SCA patients and there was no observed association of α-3.7 Kb thalassemia in SLU occurrence. Alterations in NO metabolism and hemolysis were associated with clinical evolution and severity of SLU, in addition to hemolysis modulating the etiology and recurrence of SLU. Our multifactorial analyses demonstrate and extend the role of hemolysis driving the pathophysiological mechanism of SLU.
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Affiliation(s)
- Edvan do Carmo Santos
- Laboratório de Patologia Aplicada e Genética, Departamento de Ciências Biológicas, Universidade Estadual de Santa Cruz, Ilhéus 45662-900, Brazil
| | - Paulo Vinícius Bispo Santana
- Laboratório de Patologia Aplicada e Genética, Departamento de Ciências Biológicas, Universidade Estadual de Santa Cruz, Ilhéus 45662-900, Brazil
| | - Laíne Lopes Silva de Jesus
- Laboratório de Patologia Aplicada e Genética, Departamento de Ciências Biológicas, Universidade Estadual de Santa Cruz, Ilhéus 45662-900, Brazil
| | - Gabriela Imbassahy Valentim Melo
- Laboratório de Patologia Aplicada e Genética, Departamento de Ciências Biológicas, Universidade Estadual de Santa Cruz, Ilhéus 45662-900, Brazil
| | | | - Caroline Conceição da Guarda
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil
| | - Rayra Pereira Santiago
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil
| | - Luciana Magalhães Fiuza
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil
| | - Suéllen Pinheiro Carvalho
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil
| | - Liz Oliveira dos Santos
- Centro de Ciência e Tecnologia em Energia e Sustentabilidade, Universidade Federal do Recôncavo da Bahia, Feira de Santana 44042-280, Brazil
| | - Elisângela Vitória Adorno
- Laboratório de Pesquisa em Anemias, Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador 40170-115, Brazil
| | | | | | | | - Marilda de Souza Gonçalves
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil
- Centro de Ciência e Tecnologia em Energia e Sustentabilidade, Universidade Federal do Recôncavo da Bahia, Feira de Santana 44042-280, Brazil
| | - Milena Magalhães Aleluia
- Laboratório de Patologia Aplicada e Genética, Departamento de Ciências Biológicas, Universidade Estadual de Santa Cruz, Ilhéus 45662-900, Brazil
- Correspondence: ; Tel.: +55-73-3680-5574
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Santos EDC, Melo GIV, Santana PVB, Quadros IGS, Yahouédéhou SCMA, da Guarda CC, Santiago RP, Fiuza LM, Carvalho SP, Adorno EV, Kaneto CM, Fonseca TCC, Goncalves MS, Aleluia MM. A Description of the Hemolytic Component in Sickle Leg Ulcer: The Role of Circulating miR-199a-5p, miR-144, and miR-126. Biomolecules 2022; 12:biom12020317. [PMID: 35204817 PMCID: PMC8869177 DOI: 10.3390/biom12020317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/31/2022] [Accepted: 02/05/2022] [Indexed: 12/04/2022] Open
Abstract
Sickle leg ulcers (SLU) are malleoli lesions with exuberant hemolytic pathophysiology. The microRNAs are potential genetic biomarkers for several pathologies. Thereby, we aimed to assess the expression of circulating miR-199a-5p, miR-144, and miR-126 in association with hemolytic biomarkers in SLU. This cross-sectional study included 69 patients with sickle cell disease, 52 patients without SLU (SLU-) and 17 patients with active SLU or previous history (SLU+). The results demonstrated elevated expression of circulating miR-199a-5p and miR-144 in SLU+ patients while miR-126 expression was reduced. Circulating miR-199a-5p and miR-144 were associated with hemolytic biomarkers such as LDH, indirect bilirubin, AST, GGT, iron, ferritin, RBC, hemoglobin, and NOm, in addition to association with impaired clinical profile of SLU. Furthermore, in silico analyses indicated interactions of miR-199a-5p with HIF1A, Ets-1, and TGFB2 genes, which are associated with vasculopathy and reduced NO. In contrast, miR-126 was associated with an attenuating clinical profile of SLU, in addition to not characterizing hemolysis. In summary, this study demonstrates, for the first time, that hemolytic mechanism in SLU can be characterized by circulating miR-199a-5p and miR-144. The circulating miR-126 may play a protective role in SLU. Thus, these microRNAs can support to establish prognosis and therapeutic strategy in SLU.
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Affiliation(s)
- Edvan do Carmo Santos
- Laboratório de Patologia Aplicada e Genética, Departamento de Ciências Biológicas, Universidade Estadual de Santa Cruz, Ilhéus 45662-900, BA, Brazil; (E.d.C.S.); (G.I.V.M.); (P.V.B.S.); (C.M.K.)
| | - Gabriela Imbassahy Valentim Melo
- Laboratório de Patologia Aplicada e Genética, Departamento de Ciências Biológicas, Universidade Estadual de Santa Cruz, Ilhéus 45662-900, BA, Brazil; (E.d.C.S.); (G.I.V.M.); (P.V.B.S.); (C.M.K.)
| | - Paulo Vinícius Bispo Santana
- Laboratório de Patologia Aplicada e Genética, Departamento de Ciências Biológicas, Universidade Estadual de Santa Cruz, Ilhéus 45662-900, BA, Brazil; (E.d.C.S.); (G.I.V.M.); (P.V.B.S.); (C.M.K.)
| | | | - Sètondji Cocou Modeste Alexandre Yahouédéhou
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, BA, Brazil; (S.C.M.A.Y.); (C.C.d.G.); (R.P.S.); (L.M.F.); (S.P.C.); (M.S.G.)
| | - Caroline Conceição da Guarda
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, BA, Brazil; (S.C.M.A.Y.); (C.C.d.G.); (R.P.S.); (L.M.F.); (S.P.C.); (M.S.G.)
| | - Rayra Pereira Santiago
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, BA, Brazil; (S.C.M.A.Y.); (C.C.d.G.); (R.P.S.); (L.M.F.); (S.P.C.); (M.S.G.)
| | - Luciana Magalhães Fiuza
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, BA, Brazil; (S.C.M.A.Y.); (C.C.d.G.); (R.P.S.); (L.M.F.); (S.P.C.); (M.S.G.)
- Laboratório de Pesquisa em Anemias, Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador 40170-115, BA, Brazil;
| | - Suéllen Pinheiro Carvalho
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, BA, Brazil; (S.C.M.A.Y.); (C.C.d.G.); (R.P.S.); (L.M.F.); (S.P.C.); (M.S.G.)
- Laboratório de Pesquisa em Anemias, Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador 40170-115, BA, Brazil;
| | - Elisângela Vitória Adorno
- Laboratório de Pesquisa em Anemias, Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador 40170-115, BA, Brazil;
| | - Carla Martins Kaneto
- Laboratório de Patologia Aplicada e Genética, Departamento de Ciências Biológicas, Universidade Estadual de Santa Cruz, Ilhéus 45662-900, BA, Brazil; (E.d.C.S.); (G.I.V.M.); (P.V.B.S.); (C.M.K.)
| | | | - Marilda Souza Goncalves
- Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, BA, Brazil; (S.C.M.A.Y.); (C.C.d.G.); (R.P.S.); (L.M.F.); (S.P.C.); (M.S.G.)
- Laboratório de Pesquisa em Anemias, Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador 40170-115, BA, Brazil;
| | - Milena Magalhães Aleluia
- Laboratório de Patologia Aplicada e Genética, Departamento de Ciências Biológicas, Universidade Estadual de Santa Cruz, Ilhéus 45662-900, BA, Brazil; (E.d.C.S.); (G.I.V.M.); (P.V.B.S.); (C.M.K.)
- Correspondence: ; Tel.: +55-73-3680-5574
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Santos EDC, Melo GIV, Correa BT, Yahouédéhou SCMA, Luiz LCGC, Kaneto CM, Adorno EV, Fonseca TCC, Gonçalves MS, Aleluia MM. EXPRESSÃO DE MIR-199A-5P, MIR-144 E MIR-126 CIRCULANTES NA OCORRÊNCIA E RECORRÊNCIA DE ÚLCERA DE PERNA FALCIFORME. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Santos EDC, Santana PVB, Pacheco JA, Guarda CC, Luiz LCGC, Kaneto CM, Adorno EV, Fonseca TCC, Gonçalves MS, Aleluia MM. EXPRESSÃO DO POLIMORFISMO NOS3 -786 T>C E METABÓLITOS DE ÓXIDO NÍTRICO NA OCORRÊNCIA DE ÚLCERA DE PERNA EM PACIENTES COM DOENÇA FALCIFORME. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Sardou-Cezar I, Lopes BA, Andrade FG, Fonseca TCC, Fernandez TDS, Larghero P, de Souza RQ, Loth G, Ribeiro LL, Bonfim C, Morgado ES, Marschalek R, Meyer C, Pombo-de-Oliveira MS. Therapy-related acute myeloid leukemia with KMT2A-SNX9 gene fusion associated with a hyperdiploid karyotype after hemophagocytic lymphohistiocytosis. Cancer Genet 2021; 256-257:86-90. [PMID: 34034210 DOI: 10.1016/j.cancergen.2021.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 10/06/2020] [Revised: 04/23/2021] [Accepted: 05/02/2021] [Indexed: 12/14/2022]
Abstract
Therapy-related acute myeloid leukemia (t-AML) following treatment with topoisomerase-II inhibitors has been increasingly reported. These compounds (e.g. etoposide) promote DNA damage and are associated with KMT2A rearrangements. They are widely used as first-line treatment in hemophagocytic lymphohistiocytosis (HLH). Here we describe a newborn who developed t-AML after HLH treatment. We provide detailed clinical, cytogenetic, and molecular characteristics of this patient, including the identification of a novel gene fusion - KMT2A-SNX9 - in t-AML. Considering the dismal outcome of this case, we discuss the side-effects of etoposide administration during HLH treatment in infants.
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Affiliation(s)
- Ingrid Sardou-Cezar
- Pediatric Hematology-Oncology Program, Research Center, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Bruno A Lopes
- Institute of Pharmaceutical Biology / DCAL, Goethe-University of Frankfurt, Frankfurt/Main, Germany; Laboratory of Molecular Oncohematology, Institute of Health Sciences, Universidade Federal da Bahia, Salvador, Brazil
| | - Francianne Gomes Andrade
- Pediatric Hematology-Oncology Program, Research Center, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | | | - Teresa de Souza Fernandez
- Cytogenetic Laboratory, Bone Marrow Transplantation Center, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Patrizia Larghero
- Institute of Pharmaceutical Biology / DCAL, Goethe-University of Frankfurt, Frankfurt/Main, Germany
| | - Regiana Quinto de Souza
- Department of Pediatric-Oncology, Hospital Manoel Novais Santa Casa de Misericórdia de Itabuna, Itabuna, Bahia, Brazil
| | - Gisele Loth
- Department of Pediatric Hematology and Bone Marrow Transplantation, Hospital Nossa Senhora das Graças, Curitiba, Paraná, Brazil
| | - Lisandro Lima Ribeiro
- Department of Pediatric Hematology and Bone Marrow Transplantation, Hospital Nossa Senhora das Graças, Curitiba, Paraná, Brazil
| | - Carmen Bonfim
- Department of Pediatric Hematology and Bone Marrow Transplantation, Hospital Nossa Senhora das Graças, Curitiba, Paraná, Brazil
| | - Elissa Santos Morgado
- Pediatric Hematology-Oncology Program, Research Center, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Rolf Marschalek
- Institute of Pharmaceutical Biology / DCAL, Goethe-University of Frankfurt, Frankfurt/Main, Germany
| | - Claus Meyer
- Institute of Pharmaceutical Biology / DCAL, Goethe-University of Frankfurt, Frankfurt/Main, Germany
| | - Maria S Pombo-de-Oliveira
- Pediatric Hematology-Oncology Program, Research Center, Instituto Nacional de Câncer, Rio de Janeiro, Brazil.
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Aleluia MM, Fonseca TCC, Souza RQ, Neves FI, da Guarda CC, Santiago RP, Cunha BLA, Figueiredo CVB, Santana SS, da Paz SS, Ferreira JRD, Cerqueira BAV, Gonçalves MDS. Comparative study of sickle cell anemia and hemoglobin SC disease: clinical characterization, laboratory biomarkers and genetic profiles. BMC Hematol 2017; 17:15. [PMID: 28932402 PMCID: PMC5602866 DOI: 10.1186/s12878-017-0087-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 09/05/2017] [Indexed: 12/12/2022]
Abstract
Background In this study, we evaluate the association of different clinical profiles, laboratory and genetic biomarkers in patients with sickle cell anemia (SCA) and hemoglobin SC disease (HbSC) in attempt to characterize the sickle cell disease (SCD) genotypes. Methods We conducted a cross-sectional study from 2013 to 2014 in 200 SCD individuals (141 with SCA; 59 with HbSC) and analyzed demographic data to characterize the study population. In addition, we determined the association of hematological, biochemical and genetic markers including the βS-globin gene haplotypes and the 3.7 Kb deletion of α-thalassemia (−α3.7Kb-thal), as well as the occurrence of clinical events in both SCD genotypes. Results Laboratory parameters showed a hemolytic profile associated with endothelial dysfunction in SCA individuals; however, the HbSC genotype was more associated with increased blood viscosity and inflammatory conditions. The BEN haplotype was the most frequently observed and was associated with elevated fetal hemoglobin (HbF) and low S hemoglobin (HbS). The -α3.7Kb-thal prevalence was 0.09 (9%), and it was associated with elevated hemoglobin and hematocrit concentrations. Clinical events were more frequent in SCA patients. Conclusions Our data emphasize the differences between SCA and HbSC patients based on laboratory parameters and the clinical and genetic profile of both genotypes.
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Affiliation(s)
- Milena Magalhães Aleluia
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia CEP, 40296-710 Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Teresa Cristina Cardoso Fonseca
- Centro de Referência a Doença Falciforme, Itabuna, Bahia, Brazil.,Universidade Estadual de Santa Cruz (UESC), Ilhéus, Bahia, Brazil
| | - Regiana Quinto Souza
- Centro de Referência a Doença Falciforme, Itabuna, Bahia, Brazil.,Universidade Estadual de Santa Cruz (UESC), Ilhéus, Bahia, Brazil
| | | | - Caroline Conceição da Guarda
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia CEP, 40296-710 Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Rayra Pereira Santiago
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia CEP, 40296-710 Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | | | - Camylla Villas Boas Figueiredo
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia CEP, 40296-710 Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Sânzio Silva Santana
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia CEP, 40296-710 Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Silvana Sousa da Paz
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia CEP, 40296-710 Brazil
| | - Júnia Raquel Dutra Ferreira
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia CEP, 40296-710 Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | | | - Marilda de Souza Gonçalves
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia CEP, 40296-710 Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
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10
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Viani K, Filho VO, Ferman S, Fonseca TCC, Oliveira VDC, Lemos PDSM, Barr RD, Ladas EJ. Partnership of the Sociedade Brasileira de Oncologia Pediátrica and International Society of Pediatric Oncology to improve nutritional care for children with cancer in Brazil. Rev Bras Hematol Hemoter 2017; 39:266-268. [PMID: 28830607 PMCID: PMC5568586 DOI: 10.1016/j.bjhh.2016.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 09/28/2016] [Accepted: 10/10/2016] [Indexed: 11/22/2022] Open
Abstract
The authors present a proposal of a partnership between the Sociedade Brasileira de Oncologia Pediátrica (SOBOPE) and the International Society of Pediatric Oncology (SIOP) to promote the standardization and improvement of nutritional care of kids under cancer treatment in Brazil. The results of the first meeting in Brazil as well as plans for future meetings are described.
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Affiliation(s)
- Karina Viani
- Universidade de São Paulo (USP), São Paulo, SP, Brazil.
| | | | - Sima Ferman
- Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil
| | | | | | | | - Ronald D Barr
- McMaster Children's Hospital, Hamilton, Ontario, Canada
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11
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Aleluia MM, Santiago RP, da Guarda CC, Fonseca TCC, Neves FI, Quinto RS, Figueiredo CVB, Yahouédéhou SCMA, Oliveira RM, Ferreira JRD, Cerqueira BAV, Barbosa CG, Milton JN, Steinberg MH, de Souza Gonçalves M. Genetic modulation of fetal hemoglobin in hydroxyurea-treated sickle cell anemia. Am J Hematol 2017; 92:E70-E72. [PMID: 28195442 DOI: 10.1002/ajh.24680] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 02/08/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Milena Magalhães Aleluia
- Laboratório de Hematologia e Genética Computacional, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (Fiocruz)Salvador Bahia Brasil
- Universidade Federal da Bahia (UFBA)Salvador Bahia Brasil
| | - Rayra Pereira Santiago
- Laboratório de Hematologia e Genética Computacional, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (Fiocruz)Salvador Bahia Brasil
- Universidade Federal da Bahia (UFBA)Salvador Bahia Brasil
| | - Caroline Conceição da Guarda
- Laboratório de Hematologia e Genética Computacional, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (Fiocruz)Salvador Bahia Brasil
- Universidade Federal da Bahia (UFBA)Salvador Bahia Brasil
| | | | | | | | - Camylla Villas Boas Figueiredo
- Laboratório de Hematologia e Genética Computacional, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (Fiocruz)Salvador Bahia Brasil
- Universidade Federal da Bahia (UFBA)Salvador Bahia Brasil
| | - Sètondji Cocou Modeste Alexandre Yahouédéhou
- Laboratório de Hematologia e Genética Computacional, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (Fiocruz)Salvador Bahia Brasil
- Universidade Federal da Bahia (UFBA)Salvador Bahia Brasil
| | - Rodrigo Mota Oliveira
- Laboratório de Hematologia e Genética Computacional, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (Fiocruz)Salvador Bahia Brasil
- Universidade Federal da Bahia (UFBA)Salvador Bahia Brasil
| | - Júnia Raquel Dutra Ferreira
- Laboratório de Hematologia e Genética Computacional, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (Fiocruz)Salvador Bahia Brasil
- Universidade Federal da Bahia (UFBA)Salvador Bahia Brasil
| | | | | | | | | | - Marilda de Souza Gonçalves
- Laboratório de Hematologia e Genética Computacional, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (Fiocruz)Salvador Bahia Brasil
- Universidade Federal da Bahia (UFBA)Salvador Bahia Brasil
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12
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Aleluia MM, da Guarda CC, Santiago RP, Fonseca TCC, Neves FI, de Souza RQ, Farias LA, Pimenta FA, Fiuza LM, Pitanga TN, Ferreira JRD, Adorno EV, Cerqueira BAV, Gonçalves MDS. Association of classical markers and establishment of the dyslipidemic sub-phenotype of sickle cell anemia. Lipids Health Dis 2017; 16:74. [PMID: 28399852 PMCID: PMC5387254 DOI: 10.1186/s12944-017-0454-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 11/18/2016] [Accepted: 03/13/2017] [Indexed: 02/08/2023] Open
Abstract
Background Sickle cell anemia (SCA) patients exhibit sub-phenotypes associated to hemolysis and vaso-occlusion. The disease has a chronic inflammatory nature that has been also associated to alterations in the lipid profile. This study aims to analyze hematological and biochemical parameters to provide knowledge about the SCA sub-phenotypes previously described and suggest a dyslipidemic sub-phenotype. Methods A cross-sectional study was conducted from 2013 to 2014, and 99 SCA patients in steady state were enrolled. We assessed correlations and associations with hematological and biochemical data and investigated the co-inheritance of -α3.7Kb-thalassemia (-α3.7Kb-thal). Correlation analyses were performed using Spearman and Pearson coefficient. The median of quantitative variables between two groups was compared using t-test and Mann-Whitney. P-values <0.05 were considered statistically significant. Results We found significant association of high lactate dehydrogenase levels with decreased red blood cell count and hematocrit as well as high levels of total and indirect bilirubin. SCA patients with low nitric oxide metabolites had high total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol and reduced very low-density cholesterol, triglycerides, direct bilirubin level and reticulocyte counts. In SCA patients with high-density lipoprotein cholesterol greater than 40 mg/dL, we observed increased red blood cell count, hemoglobin, hematocrit, and fetal hemoglobin and decreased nitric oxide metabolites levels. The presence of -α3.7Kb-thal was associated with high red blood cell count and low mean corpuscular volume, mean corpuscular hemoglobin, platelet count and total and indirect bilirubin levels. Conclusions Our results provide additional information about the association between biomarkers and co-inheritance of -α3.7Kb-thal in SCA, and suggest the role of dyslipidemia and nitric oxide metabolites in the characterization of this sub-phenotype.
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Affiliation(s)
- Milena Magalhães Aleluia
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Caroline Conceição da Guarda
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Rayra Pereira Santiago
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Teresa Cristina Cardoso Fonseca
- Centro de Referência a Doença Falciforme de Itabuna, Itabuna, Bahia, Brazil.,Universidade Estadual de Santa Cruz (UESC), Ilhéus, Bahia, Brazil
| | | | - Regiana Quinto de Souza
- Centro de Referência a Doença Falciforme de Itabuna, Itabuna, Bahia, Brazil.,Universidade Estadual de Santa Cruz (UESC), Ilhéus, Bahia, Brazil
| | | | | | - Luciana Magalhães Fiuza
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Thassila Nogueira Pitanga
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil
| | - Júnia Raquel Dutra Ferreira
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil.,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | | | | | - Marilda de Souza Gonçalves
- Laboratório de Hematologia e Genética Computacional, Instituto Gonçalo Moniz - IGM, Rua Waldemar Falcão, 121, Candeal - Salvador/BA, CEP: 40296-710, Bahia, Brazil. .,Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.
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13
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Maiolino A, Simões BP, de Castro CG, Covas DT, Dos Santos Fernandes G, Hamerschlak N, Fonseca TCC, Colturato V. Paradoxes of hematology: When the old disappears and the new does not arrive. Rev Bras Hematol Hemoter 2017; 39:1-3. [PMID: 28270339 PMCID: PMC5339406 DOI: 10.1016/j.bjhh.2017.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Angelo Maiolino
- Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH), Comitê de Mieloma Múltiplo, Brazil; International Myeloma Foundation-Latin America (IMF), Brazil
| | - Belinda Pinto Simões
- Sociedade Brasileira de Transplante de Medula Óssea (SBTMO), Brazil; Latin American Bone Marrow Transplant Association (LABMT), Brazil.
| | - Claudio Galvão de Castro
- Sociedade Brasileira de Oncologia Pediátrica (SOBOPE), Brazil; Santa Casa de Porto Alegre, Unidade de Hematologia/Oncologia Pediátrica, Porto Alegre, RS, Brazil
| | - Dimas Tadeu Covas
- Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH), Brazil
| | | | - Nelson Hamerschlak
- Universidade de São Paulo (USP), Faculdade de Medicina, São Paulo, SP, Brazil; Hospital Israelita Albert Einstein, Programa de Hematologia e Transplante de Medula Óssea, São Paulo, SP, Brazil; Associação Brasileira de Linfoma e Leucemia (ABRALE), Brazil
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14
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Andrade FG, Noronha EP, Baseggio RM, Fonseca TCC, Freire BMR, Quezado Magalhaes IM, Zalcberg IR, Pombo-de-Oliveira MS. Identification of the MYST3-CREBBP fusion gene in infants with acute myeloid leukemia and hemophagocytosis. Rev Bras Hematol Hemoter 2016; 38:291-297. [PMID: 27863755 PMCID: PMC5119666 DOI: 10.1016/j.bjhh.2016.06.005] [Citation(s) in RCA: 6] [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: 06/25/2015] [Revised: 06/07/2016] [Accepted: 06/16/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Acute myeloid leukemia presenting the MYST3-CREBBP fusion gene is a rare subgroup associated with hemophagocytosis in early infancy and monocytic differentiation. The aim of this study was to define the relevant molecular cytogenetic characteristics of a unique series of early infancy acute myeloid leukemia cases (≤24months old), based on the presence of hemophagocytosis by blast cells at diagnosis. METHODS A series of 266 infant cases of acute myeloid leukemia was the reference cohort for the present analysis. Acute myeloid leukemia cases with hemophagocytosis by blast cells were reviewed to investigate the presence of the MYST3-CREBBP fusion gene by fluorescence in situ hybridization (FISH) and reverse transcription polymerase chain reaction. RESULTS Eleven cases with hemophagocytosis were identified with hemophagocytic lymphohistiocytosis being ruled out. Six cases were classified as myelomonocytic leukemia, three as AML-M7 and two as AML-M2. In five cases, the presence of the MYST3-CREBBP fusion gene identified by molecular cytogenetics was confirmed by fluorescence in situ hybridization. All patients received treatment according to the Berlin-Frankfürt-Münster acute myeloid leukemia protocols and only one out of the five patients with the MYST3-CREBBP fusion gene is still alive. CONCLUSIONS Our findings demonstrate that the presence of hemophagocytosis in acute myeloid leukemia was not exclusively associated to the MYST3-CREBBP fusion gene. Improvements in molecular cytogenetics may help to elucidate more complex chromosomal rearrangements in infants with acute myeloid leukemia and hemophagocytosis.
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Affiliation(s)
| | | | - Rosania Maria Baseggio
- Hospital Regional do Mato Grosso do Sul Rosa Pedrossian (HRMS), Campo Grande, MS, Brazil
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15
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Abstract
UNLABELLED A Severe Aplastic Anemia is a rare disease that happens in the entire world. Because the rarity, it is difficult to characterize the features of the patients that have this disease, and to find their possible etiological factors. PURPOSE To report all cases of severe aplastic anemia in young people who were attended in the hospital and characterize some variables like age, sex, geographic area of residence, etiologies and socioeconomic status. METHODS It was done a descriptive analyze of all pediatric patient's features (below 18 years) who came to the hospital in 1979-1993 with severe aplastic anemia based on the classification proposed for Camitta et al. The data were obtained from the hospital records in 134 children, and the investigator in 79 families performed interviews. RESULTS The age ranged from 2-18 years (mean 10.89 years). The male to female ratio was 64:70. Most of the patients came from urban zone of south Brazil. We did not identify any etiologic agents in 34% of the cases. Prior exposure to the agricultural pesticides and benzene derivative was the most common etiologic factors that were related. The household income of 83.5% of the families was < $ 65 U.S./capita, and 70.9% of the patient's mother did not finish the primary school CONCLUSION. In this group, severe aplastic anemia is more frequent in 11 years old girls. Most of them are the in urban zone of south Brazil, with low socioeconomic status, and related prior exposure agricultural pesticides and benzene derivative.
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