Navegando por Assunto "Leucemia"

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Acesso aberto (Open Access)
Analysis of imatinib adherence in chronic myeloid leukemia: a retrospective study in a referral hospital in the brazilian amazon
(Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular, 2019-06) ANDRADE, Alan Rodrigues; PAZ, Igor Penha; EVANGELISTA, Talitta Ribeiro; MELLO, Vanessa Joia de; HAMOY, Moisés; LEITÃO, Daniel da Silva
Background: There has been a revolution in the treatment of Chronic Myeloid Leukemia since imatinib's introduction. However, patient adherence has a great impact on the response obtained with medical treatment. This study's objective was to analyze the drug adherence and the factors that influenced it in patients with Chronic Myeloid Leukemia in a referral hospital in the Brazilian Amazon. Method: This was a retrospective study including 120 patients with Chronic Myeloid Leukemia from January 2002 to December 2014. The adherence was estimated by the Proportion of Days Covered and the persistence by Kaplan-Meier analysis. The data was analyzed in Epi Info 7® software and the relationship between the variables was analyzed by Fisher's exact test. A p-value lower than 0.05 was considered significant. Results: Twenty-seven patients (22.5%) were considered non-adherent. There has been irregular medication use and disinterest in the treatment in 20.83% (n = 25), of which 13 were considered non-adherent (p < 0.001). A total of 26.67% (n = 32) abandoned the treatment for a period. Of those, 56.25% (n = 18) were non-adherent (p < 0.001). Distance to the hospital, lack of medication and side-effects were all non-significant to low adherence. At the end of a 360-day follow-up, 44.16% (n = 53) of patients presented a break in persistence, whose average was 255 days. Conclusion: The adherence found in this study was similar to that found in others of its kind. The only factors that negatively influenced the adherence were disinterest and abandonment of treatment, which can reflect the need to individually educate Chronic Myeloid Leukemia patients.
Acesso aberto (Open Access)
Aspectos hematológicos e clínicos de crianças leucêmicas no período de indução da quimioterapia
(Universidade Federal do Pará, 2012-09-22) MÉLO, Flávia Maria Lessa; QUARESMA, Juarez Antônio Simões; http://lattes.cnpq.br/3350166863853054
The leukemia happens in approximately 30% of cases of pediatric malignant diseases involving the hematopoietic system, affects preferentially the white blood cells, characterized by replacement of normal blood cells to young abnormal cells in the bone marrow. Te leukemia is the most common cause of cancer deaths in childhood, and the main types are: acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) or chronic (CML). Chemotherapy is a specific treatment and the most used for healing or prolong life of these patients, often requiring hospitalization, since these patients show significant changes in blood counts, making them immunocompromised. This increases the risk of potentially serious infections and other complications that often prolong hospital stay and increase the rates of morbidity and mortality. In order to broaden the knowledge about the hematology and clinical characteristics of pediatric leukemia patients during chemotherapy induction in an oncology hospital reference in the northern region of Brazil from 2005 to 2010 aged 0-12 years. Therefore was made a retrospective study with secondary data collection from records filed on the division of medical records and statistics of the hospital involved in the study. In the statistical analysis of the results we obtained mean, standard deviation and median of continuous variables and frequency of categorical variables, and statistical significance assessed by means of obtaining confidence intervals at 95% and by an ANOVA test and Wilcoxon considered α = 5%. These analyzes were performed in Epi-Info software 3.5.1. Of the 556 medical records, 141 were complete, and observed higher prevalence in masculine gender, age group between 1-4 years, coming from the state of Pará, with clinical classification for ALL, with Brazilian protocol GBTLI selected in most cases, making use of empirical antibiotic therapy, especially ceftazidime, amikacin and ceftriaxone, and records of use of blood bag during hospitalization, and the outcome of the type of hospital discharge. The study also revealed alteration of the data found in all variables in the blood count to the white and red, both the first and the fifteenth day of hospitalization these periods chosen for data collection hematological, and found use in blood bags virtually all hospitalized patients (92.20%) with predominance of platelet concentrate (CP5), leukocyte-poor red blood cells (CHPL) and red blood cells. Given the above, it is recommended the development of strategic actions and local policies that address not only the tertiary specialist in pediatric oncology, but all levels of health care for the child, to reduce the impact of this disease in the pediatric population the northern region.
Acesso aberto (Open Access)
Estudo da função tímica em portadores de HTLV-1 com PET/MAH
(Universidade Federal do Pará, 2017) GOMES, Jéssica Antonia Nunes; FUZII, Hellen Thais; http://lattes.cnpq.br/0026958665547973
In HTLV-1 infeccions 90% of carriers remain asymptomatic, 2-3% develop Adult T-cell leukemia/lymphoma (ATL) and 0.25-4% develop HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP). In HAM/TSP, specific CD8 + T cell infiltrates are found in the marrow that destroy infected CD4 + T cells, leading to a chronic activated immune response. Recently emigrated T cells (or naïve T cells) have excised circles by the rearrangement of T cell receptor (TREC) genes that do not double in cell proliferation, being a good indicator to quantify the number of naïve T cells and thus evaluate the thymic function. This study aimed to verify the thymic function of patients with HTLV-1 infection by quantifying the number of TREC in peripheral blood mononuclear cells. This is a cross-sectional, analytical study of 39 patients over 18 years of age, divided into two groups: HAM/TSP (PET) and without HAM/TSP (NPET). We performed a clinical and physiotherapeutic evaluation, blood collection, lymphomononuclear cell separation, DNA and RNA extraction, absolute TREC curve, DNA and RNA quantification, TREC particle detection and quantification, cDNA synthesis, cytokine IL-7 and statistical analysis with the Mann-Whitney tests and Spearman's correlation, with p ≤ 0.05 as significance level. Of the 39 patients studied, two were excluded from the study because they presented autoimmune disease. Regarding the comparison between groups of TREC quantification: there was a difference between the PET and NPET groups (p = 0.01), in patients with age ≤59 years between the PET and NPET groups (p = 0.04), in the (p = 0.003) and the group with a wheelchair and without a wheelchair (p = 0.05). As for the comparison of IL-7 gene expression between groups: in the NPET group there was a difference between the group ≤59 years and the ≥60 years (p = 0.02), in the female there was a difference between the PET and NPET groups (p = 0.04). Thymic function was impaired in patients with HTLV-1 with HAM/TSP compared to those without HAM/TSP, as there was a loss in naïve T cell production in this population, shown by the differences between variables in both PET and NPET groups With respect to the quantification of TREC. Although the importance of this compromise in the triggering and / or evolution of HAM/TSP is not yet clear, it is inferred that the reduction of naïve T cell production can alter the immunological response in these patients, directly affecting their clinical picture.
Acesso aberto (Open Access)
Farmacogenética do Gene TPMT na resposta A 6-Mercaptopurina, em pacientes com Leucemia Linfoblástica Aguda
(Universidade Federal do Pará, 2016-03-03) LIMA, Carlos Henrique Vasconcelos de; ASSUMPÇÃO, Paulo Pimentel de; http://lattes.cnpq.br/7323606327039876; SANTOS, Ney Pereira Carneiro dos; http://lattes.cnpq.br/1290427033107137
Acute Lymphoblastic Leukemia (ALL) is the most common type of cancer in children under 15 years of age. 6-mercaptopurine (6-MP) is one of the most widely used chemotherapeutic agents in the treatment of childhood ALL. Polymorphisms in thiopurine S-methyltransferase gene (TPMT) may be associated with individual variation in the response to treatment of childhood ALL, such as increased severe toxicity (grade 3 and 4). The aim of this study was to associate polymorphisms of TPMT gene: TPMT*2 (238G>C), TPMT*3A (460G>A and 719A>G), TPMT*3B (460G>A), TPMT*3C (719A>G), TPMT* 8 (644G>A) and intronic variant rs12201199 (94T>A) with the occurrence of serious toxicities in patients with ALL treated with 6-MP, in Northern Brazil. One hundred thirty-seven pediatric patients with ALL and treated at the Ophir Loyola Hospital in the state of Pará were investigated. The rs12201199 polymorphism was genotyped by real-time PCR (equipment 7500 Real-Time PCR System) and other polymorphisms were genotyped by direct sequencing using the automated sequencer ABI PRISM 3130 Genetic Analyzer (Applied Biosytems, CA, USA). The haplotypes among the studied polymorphisms were derived via maximum likelihood estimates using the program PHASE. A panel of 48 markers Ancestry Informative was used as genomic control in the sample and statistical analyses were performed using SPSS v.20.0 software (SPSS, Chicago, IL, USA). All statistical tests considered the probability (p) significant when ≤0, 05. In relation to the genomic ancestry, it was noted that the ethnic composition of ALL patients was 44% Caucasian, 22% African and 34% Amerindian. Among the reported toxicities, infectious was most prevalent (86%), followed by hematological (65%), gastrointestinal (64.8%) and central nervous system toxicity (29.9%). Allele frequency of polymorphism rs12201199 was 0.482 among the studied subjects. The most prevalent haplotype variants were TPMT*3A (7.6%), followed by TPMT*3C and TPMT*8, both 7.3%. There was no significant association between poor metabolism profiles of TPMT with none of the serious toxicities reported in the studied patients with LLA. However, our data show that there is a significant relationship between the polymorphism of TPMT gene (rs12201199) and the occurrence of severe infectious toxicity during treatment of childhood ALL. It has been observed that patients who have mutant homozygous AA genotype for this polymorphism in TPMT gene have 4.098 times higher risk of presenting severe infectious toxicity during the treatment for childhood ALL compared to those with the other genotypes. This result may be important to help predict risk of toxicity during treatment, contributing to a better individual prognosis of patients with childhood ALL.
Acesso aberto (Open Access)
Prevalence of HTLV-I antibody among two distinct ethnic groups inhabiting the Amazon region of Brazil
(1992-08) NAKAUCHI, C. M.; MARUYAMA, Koshi; KANZAKI, Luis Isamu Barros; LINHARES, Alexandre da Costa; AZEVEDO, Vânia Nakauth; FUKUSHIMA, T.; MIYAUCHI, M.; KOSHIKAWA, N.; TAMAYAMA, C.; MOCHIZUKI, S.; KAWAMURA, K.
HTLV-I seroprevalences of 3.63% (02/55), 12.19% (10/82) and 13.88% (10/72) were demonstrated among Tiryio, Mekranoiti and Xicrin Amazonian Indians, respectively, by the Western blotting enzyme assay (WBEI). By indirect immuno electron microscopy (IIEM), 2 Tiriyo, 9 Mekranoiti and 6 Xicrin Amerindians were reactive. Of 44 serum samples from Japanese immigrants, none reacted by any of the techniques before mentioned. One, 8 and 6 serum samples from Tiryio, Mekranoiti and Xicrin Indians, respectively, were both WBEI and IIEM positive. Our results strongly suggest that HTLV-I and/or an HTLV-I antigenic variant circulate (s) among populations living in the Amazon region of Brazil.
Acesso aberto (Open Access)
Prevalence of human T cell leukemia virus-I (HTLV-I) antibody among populations living in the Amazon region of Brazil (preliminary report)
(1990-03) NAKAUCHI, C. M.; LINHARES, Alexandre da Costa; MARUYAMA, Koshi; KANZAKI, Luis Isamu Barros; MACEDO, J. E.; AZEVEDO, Vânia Nakauth; CASSEB, Jorge Simão do Rosário
Prevalence of human T cell leukemia virus-I (HTLV-I) antibody among populations living in the Amazon region of Brazil (preliminary report)NakauchiC. M.LinharesA. C.MaruyamaK.KanzakiL. I.MacedoJ. E.AzevedoV. N.CassebJ. S. R. Fundação Serviços de Saúde Pública, Seção de Vírus, Instituto Evandro Chagas Belém Brasil Chiba Cancer Research Institute, Department of Pathology Chiba Japan Universidade Federal do Pará Belém Brasil Instituto Offir Loyola Belém Brasil Faculdade Estadual de Medicina Belém Brasil 0319908512933Forty-tree (31.4%) out of 137 serum samples obtained from two Indian communities living in the Amazon region were found to be positive for HTLV-I antibody, as tested by enzyme-linked immunosorbent assay (Elisa). Eighty-two sera were collected from Mekranoiti Indians, yielding 39% of positivity, whereas 11 (20.0%) or the 55 Tiriyo serum samples had antibody to HTLV-I. In addition, positive results occurred in 10 (23.2%) out of 43 sera obtained from patients living in the Belem area, who were suffering from cancer affecting different organs. Five (16.7%) out of 30 Elisa positive specimens were also shown to be positive by either Western blot analysis (WB) or indirect immunogold electron microscopy (IIG-EM).
Acesso aberto (Open Access)
Prevalência de sintomas urinários em indivíduos portadores do Vírus Linfotrópico de Células T Humanas do tipo 1 (HTVL-1)
(Universidade Federal do Pará, 2014) CONSTANTE, Caroline Santos; CRESCENTE, José Ângelo Barletta; http://lattes.cnpq.br/5243773796185944
The human T-cells lymphotropic virus type 1 (HTLV-I) infects approximately 20 million people worldwide. It is mainly associated with adult T-cell leukemia/lymphoma (ATLL) and a neurological disease HLTV associated myelopathy/ tropical spastic paraparesis (HAM/TSP). The HAM/TSP causes motor abnormalities, weakness, increased tone in the lower limbs, urinary and erectile dysfunction. Studies show that there is a tendency of patients with HTLV-I to have some urinary symptoms. These symptoms persist not only in individuals with HAM/TSP, but also in individuals considered as asymptomatic carriers. This highlights the importance of studies that address the multitude of urinary symptoms in individuals with HTLV-I in order to deepen the scientific knowledge of the clinical progression of HTLV-I infected individuals, facilitate diagnosis, allow for earlier interventions and improve the quality of life and health of patients with HTLV-I. This research was aimed to determine the prevalence of urinary symptoms among individuals with HTLV-I with the specific objectives to describe the socio-demographic characteristics; identify the most frequent urinary symptoms reported; verify the association of the presence of urinary symptoms to neurological findings and analyze the impact on quality of life of urinary symptoms in individuals with HTLV-I. The study involved cross-sectional analysis involving 45 individuals with HTLV-I through the outpatient clinic at the NMT/UFPA. Through clinical neurological evaluation, the presence of urinary symptoms and impact assessment of urinary symptoms on quality of life by carriers HTLV-I was assessed applying the King's Health Questionnaire. The sample have had an average of 48.82 years of age, most were asymptomatic (64,44%), female (64,44%), married (64,44%), with primary education (53,33%) and without knowledge of its mode of infection (53,33%). The prevalence of urinary symptoms was 73,33% being 69% among patients with asymptomatic HTVL-I and 81,3% among individuals with HAM/TSP. The most common urinary symptoms were nocturia (71.11%), urinary urgency with incontinence (44.44%) and urinary urgency (42.22%). There was no association between neurological findings and the presence of urinary symptoms and the assessment of quality of life showed negative impact on seven of the nine areas covered by the questionnaire. High prevalence of urinary symptoms was found in individuals with HTLV-I, not only in individuals with HAM/TSP, but also in patients considered asymptomatic carriers. It is suggested that further studies with larger sample sizes and more accurate diagnostic tests to clarify development of these symptoms among asymptomatic carriers and its relationship with the worsening of myelopathy.