1
|
de Molla VC, Barbosa MCR, Junior AM, Gonçalves MV, Guirao EKF, Yamamoto M, Arrais-Rodrigues C. Natural killer cells 56 bright16 - have higher counts in the umbilical cord blood than in the adult peripheral blood. Hematol Transfus Cell Ther 2023; 45:419-427. [PMID: 36100550 PMCID: PMC10627873 DOI: 10.1016/j.htct.2022.07.001] [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: 01/31/2022] [Revised: 06/05/2022] [Accepted: 07/03/2022] [Indexed: 10/15/2022] Open
Abstract
INTRODUCTION AND HYPOTHESIS Umbilical cord blood (UCB) is an alternative source of hematopoietic stem cells for allogeneic hematopoietic stem cell transplantation in the absence of a compatible donor. The UCB transplantation has a lower incidence of chronic graft versus host disease (GvHD), but is associated with slower engraftment and slower immune reconstitution, compared to other sources. Dendritic cells (DCs) and Natural Killer cells (NKs) play a central role in the development of GvHD and the graft versus leukemia (GvL) effect, as well as in the control of infectious complications. METHOD We quantified by multiparametric flow cytometry monocytes, lymphocytes, NK cells, and DCs, including their subsets, in UCB samples from 54 healthy newborns and peripheral blood (PB) from 25 healthy adult volunteers. RESULTS In the UCB samples, there were higher counts of NK cells 56bright16- (median 0.024 × 109/L), compared to the PB samples (0.012 × 109/L, p < 0.0001), NK 56dim16bright (median 0.446 × 109/L vs. 0.259 × 109/L for PB samples, p = 0.001) and plasmacytoid dendritic cells (pDCs, median 0.008 × 109/L for UCB samples vs. 0.006 × 109/L for PB samples, p = 0.03). Moreover, non-classic monocyte counts were lower in UCB than in PB (median 0.024 × 109/L vs. 0.051 × 109/L, respectively, p < 0.0001). CONCLUSION In conclusion, there were higher counts of NK cells and pDCs and lower counts of non-classic monocytes in UCB than in PB from healthy individuals. These findings might explain the lower incidence and severity of chronic GvHD, although maintaining the GvL effect, in UCB transplant recipients, compared to other stem cell sources.
Collapse
Affiliation(s)
- Vinicius Campos de Molla
- Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil; Hospital 9 de Julho, São Paulo, Brazil
| | | | | | | | | | - Mihoko Yamamoto
- Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil
| | - Celso Arrais-Rodrigues
- Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil; Hospital 9 de Julho, São Paulo, Brazil
| |
Collapse
|
2
|
Yamakawa PE, Fonseca AR, Guerreiro da Silva IDC, Gonçalves MV, Marchioni DM, Carioca AAF, Michonneau D, Arrais-Rodrigues C. Biochemical phenotyping of paroxysmal nocturnal hemoglobinuria reveals solute carriers and β-oxidation deficiencies. PLoS One 2023; 18:e0289285. [PMID: 37527257 PMCID: PMC10393180 DOI: 10.1371/journal.pone.0289285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/11/2023] [Indexed: 08/03/2023] Open
Abstract
INTRODUCTION Paroxysmal nocturnal hemoglobinuria (PNH) is a clonal disease of hematopoietic cells with a variable clinical spectrum characterized by intravascular hemolysis, high risk of thrombosis, and cytopenias. To understand the biochemical shifts underlying PNH, this study aimed to search for the dysfunctional pathways involved in PNH physiopathology by comparing the systemic metabolic profiles of affected patients to healthy controls and the metabolomic profiles before and after the administration of eculizumab in PNH patients undergoing treatment. METHODS Plasma metabolic profiles, comprising 186 specific annotated metabolites, were quantified using targeted quantitative electrospray ionization tandem mass spectrometry in 23 PNH patients and 166 population-based controls. In addition, samples from 12 PNH patients on regular eculizumab maintenance therapy collected before and 24 hours after eculizumab infusion were also analyzed. RESULTS In the PNH group, levels of the long-chain acylcarnitines metabolites were significantly higher as compared to the controls, while levels of histidine, taurine, glutamate, glutamine, aspartate and phosphatidylcholines were significantly lower in the PNH group. These differences suggest altered acylcarnitine balance, reduction in the amino acids participating in the glycogenesis pathway and impaired glutaminolysis. In 12 PNH patients who were receiving regular eculizumab therapy, the concentrations of acylcarnitine C6:1, the C14:1/C6 ratio (reflecting the impaired action of the medium-chain acyl-Co A dehydrogenase), and the C4/C6 ratio (reflecting the impaired action of short-chain acyl-Co A dehydrogenase) were significantly reduced immediately before eculizumab infusion, revealing impairments in the Acyl CoA metabolism, and reached levels similar to those in the healthy controls 24 hours after infusion. CONCLUSIONS We demonstrated significant differences in the metabolomes of the PNH patients compared to healthy controls. Eculizumab infusion seemed to improve deficiencies in the acyl CoA metabolism and may have a role in the mitochondrial oxidative process of long and medium-chain fatty acids, reducing oxidative stress, and inflammation.
Collapse
Affiliation(s)
| | - Ana Rita Fonseca
- Hematology Division, Universidade Federal de São Paulo, São Paulo, Brazil
- Oncology Department, Hospital Sírio Libanês, São Paulo, Brazil
| | | | | | - Dirce Maria Marchioni
- Nutrition Department, School of Public Health, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - David Michonneau
- Hematology and Bone Marrow Transplant Department of the Saint-Louis Hospital, Paris, France
| | - Celso Arrais-Rodrigues
- Hematology Division, Universidade Federal de São Paulo, São Paulo, Brazil
- Hematology Department, Hospital Nove de Julho, DASA, São Paulo, Brazil
| |
Collapse
|
3
|
Carneiro TX, Marrese DG, Dos Santos MG, Gonçalves MV, Novis YAS, Rizzatti EG, Rocha V, Sandes AF, de Lacerda MP, Arrais-Rodrigues C. Circulating extracellular vesicles as a predictive biomarker for acute graft-versus-host disease. Exp Hematol 2023; 117:15-23. [PMID: 36400315 DOI: 10.1016/j.exphem.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/19/2022]
Abstract
The diagnosis and management of graft-versus-host disease (GVHD) have remained important challenges in allogeneic stem cell transplantation (allo-SCT). Novel diagnostic methods and therapeutic interventions are needed to further improve on patient outcomes. Extracellular vesicles (EV) are microvesicles formed by the inversion of the phospholipid bilayer of different cellular subtypes and have been described as biomarkers of cellular damage, activation, and intercellular signaling in numerous clinical scenarios. We studied the association between the levels of EV and the incidence of acute GVHD (aGVHD). Forty patients undergoing allo-SCT for hematological malignancies had their plasma collected at neutrophil engraftment. Using flow cytometry combined with fluorescent beads, the total circulating EV count (TEV) was established with annexin V positivity; CD61 positivity was used for platelet-derived EV (PEV), and CD235 positivity, for erythrocyte-derived EV (EryEV). TEV counts greater than 516/μL were associated with a higher cumulative incidence (CI) of grade II to IV aGVHD (54% vs. 21%; p = 0.02), as were EryEV counts above 357 /μL (CI of aGVHD: 59% vs. 26%; p = 0.04). In patients who are exposed to reduced intensity conditioning (RIC), stronger associations of both high TEV and EryEV counts with aGVHD were observed (77% vs. 22%; p = 0.003 and 89% vs. 27%; p = 0.002, respectively). PEV levels were not associated with the risk of aGVHD. Our data suggest that the measurement of cell-derived EV at engraftment can be used as a preemptive biomarker for acute GVHD.
Collapse
Affiliation(s)
- Thiago Xavier Carneiro
- Centro de Oncologia, Hospital Sirio Libanes, São Paulo, São Paulo, Brazil; Disciplina de Hematologia, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil.
| | - Daniella Gregolin Marrese
- Disciplina de Hematologia, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil; Grupo Fleury, São Paulo, Brazil
| | - Melina Gonçalves Dos Santos
- Disciplina de Hematologia, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil; Grupo Fleury, São Paulo, Brazil
| | - Matheus Vescovi Gonçalves
- Disciplina de Hematologia, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil; Grupo Fleury, São Paulo, Brazil
| | | | | | - Vanderson Rocha
- Centro de Oncologia, Hospital Sirio Libanes, São Paulo, São Paulo, Brazil
| | | | | | - Celso Arrais-Rodrigues
- Centro de Oncologia, Hospital Sirio Libanes, São Paulo, São Paulo, Brazil; Disciplina de Hematologia, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil
| |
Collapse
|
4
|
Fernandes PA, Marques FM, Pfister V, Fortier S, Santucci R, Hamerschlak N, Perobelli LLM, Figueiredo V, Gonçalves MV, Arrais-Rodrigues C, Chiattone CS. CARACTERÍSTICAS CLÍNICAS E DESFECHOS DE PACIENTES COM LEUCEMIA LINFOCÍTICA CRÔNICA (LLC) COM DEL17P POR FISH (HIBRIDAÇÃO IN SITU POR FLUORESCÊNCIA) E/OU MUTAÇÃO DO TP53 AO DIAGNÓSTICO: ANÁLISE RETROSPECTIVA DO REGISTRO BRASILEIRO DE LLC. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.234] [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: 11/05/2022] Open
|
5
|
Pfister V, Marques FDM, Parra F, Yamamoto M, Gonçalves MV, Perobelli L, Buccheri V, Bandeira R, Fortier S, Azevedo A, Santucci R, Bellesso M, Fogliatto L, Ribeiro G, Lopes GS, Ikoma M, Figueiredo VP, Metze IGHL, Chiattone CS, Arrais‐Rodrigues C. Lower access to risk stratification tests and drugs, and worse survival of chronic lymphocytic leukaemia patients treated in public as compared to private hospitals in Brazil: A retrospective analysis of the Brazilian registry of chronic lymphocytic leukaemia. eJHaem 2022; 3:698-706. [PMID: 36051063 PMCID: PMC9422035 DOI: 10.1002/jha2.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/24/2022] [Accepted: 03/26/2022] [Indexed: 11/22/2022]
Abstract
Chronic lymphocytic leukaemia (CLL) has a highly variable clinical course. In addition to biological factors, socioeconomic factors and health system characteristics may influence CLL outcome. Data from the Brazilian Registry of CLL were analyzed to compare clinical and treatment‐related characteristics in patients with CLL, from public or private institutions. A total of 3326 patients from 43 centres met the eligibility criteria, of whom 81% were followed up at public hospitals and 19% at private hospitals. The majority were male (57%), with a median age of 65 years. Comparing public and private hospitals, patients in public hospitals were older, had more advanced disease at diagnosis, and more frequently had elevated creatinine levels. All investigated prognostic markers were evaluated more often in private hospitals. First‐line treatment was predominantly based on chlorambucil in 41% of the cases and fludarabine in 38%. Anti‐CD20 monoclonal antibody was used in only 36% of cases. In public hospitals, significantly fewer patients received fludarabine‐based regimens and anti‐CD20 monoclonal antibodies. Patients from public hospitals had significantly worse overall survival (71% vs. 90% for private hospitals, p < 0.0001) and treatment‐free survival (32% vs. 40%, for private hospitals, p < 0.0001) at seven years. Our data indicate striking differences between patients followed in public and private hospitals in Brazil. A worse clinical condition and lack of accessibility to basic laboratory tests and adequate therapies may explain the worse outcomes of patients treated in public institutions.
Collapse
Affiliation(s)
- Verena Pfister
- Escola Paulista de Medicina /Universidade Federal de São Paulo, UNIFESP São Paulo Brazil
- Brazilian Registry of CLL – Associação Brasileira de Hematologia e Hemoterapia Hemoterapia Brazil
| | - Fernanda de Morais Marques
- Escola Paulista de Medicina /Universidade Federal de São Paulo, UNIFESP São Paulo Brazil
- Brazilian Registry of CLL – Associação Brasileira de Hematologia e Hemoterapia Hemoterapia Brazil
- Hospital Brigadeiro São Paulo Brazil
| | - Flavia Parra
- Brazilian Registry of CLL – Associação Brasileira de Hematologia e Hemoterapia Hemoterapia Brazil
| | - Mihoko Yamamoto
- Escola Paulista de Medicina /Universidade Federal de São Paulo, UNIFESP São Paulo Brazil
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Celso Arrais‐Rodrigues
- Escola Paulista de Medicina /Universidade Federal de São Paulo, UNIFESP São Paulo Brazil
- Brazilian Registry of CLL – Associação Brasileira de Hematologia e Hemoterapia Hemoterapia Brazil
- Hospital 9 de Julho São Paulo Brazil
| |
Collapse
|
6
|
Silva MP, Jacinto DM, Fuchs TA, Takihi IY, Gouvea CP, Chauffaille MLLF, Perazzio ADSB, Silva MCA, Sandes AF, Gonçalves MV. TROMBOCITOPENIA MEDICAMENTOSA: O ANTIGO E O NOVO. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.740] [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
|
7
|
Marques FM, Pfister V, Perobelli LLM, Santucci R, Buccheri V, Soares TB, Azevedo A, Gonçalves MV, Chiattone CS, Arrais-Rodrigues C. OUTCOMES OF PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) ACCORDING TO THE REASONS FOR INITIATION OF FIRST-LINE TREATMENT: A RETROSPECTIVE ANALYSIS OF THE BRAZILIAN REGISTRY OF CLL. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.200] [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: 11/25/2022] Open
|
8
|
de Faria-Moss M, Yamamoto M, Arrais-Rodrigues C, Criado I, Gomes CP, de Lourdes Chauffaille M, Gonçalves MV, Kimura E, Koulieris E, Borges F, Dighiero G, Pesquero JB, Almeida J, Orfao A. High frequency of chronic lymphocytic leukemia-like low-count monoclonal B-cell lymphocytosis in Japanese descendants living in Brazil. Haematologica 2019; 105:e298-e301. [PMID: 31727770 DOI: 10.3324/haematol.2019.230813] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Mariane de Faria-Moss
- Division of Hematology, Universidade Federal de São Paulo (EPM-UNIFESP), Sao Paulo, Brazil
| | - Mihoko Yamamoto
- Division of Hematology, Universidade Federal de São Paulo (EPM-UNIFESP), Sao Paulo, Brazil
| | - Celso Arrais-Rodrigues
- Division of Hematology, Universidade Federal de São Paulo (EPM-UNIFESP), Sao Paulo, Brazil
| | - Ignacio Criado
- Cancer Research Center, Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL) and CIBERONC CB16/12/00400 (Centro de Investigación Biomédica en Red de CÁNCER), Salamanca, Spain
| | - Caio Perez Gomes
- Division of Hematology, Universidade Federal de São Paulo (EPM-UNIFESP), Sao Paulo, Brazil.,Department of Biophysics (EPM-UNIFESP), Sao Paulo, Brazil
| | | | | | - Eliza Kimura
- Division of Hematology, Universidade Federal de São Paulo (EPM-UNIFESP), Sao Paulo, Brazil
| | - Efstathios Koulieris
- Cancer Research Center, Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL) and CIBERONC CB16/12/00400 (Centro de Investigación Biomédica en Red de CÁNCER), Salamanca, Spain
| | - Fabio Borges
- Division of Hematology, Universidade Federal de São Paulo (EPM-UNIFESP), Sao Paulo, Brazil
| | | | | | - Julia Almeida
- Cancer Research Center, Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL) and CIBERONC CB16/12/00400 (Centro de Investigación Biomédica en Red de CÁNCER), Salamanca, Spain
| | - Alberto Orfao
- Cancer Research Center, Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL) and CIBERONC CB16/12/00400 (Centro de Investigación Biomédica en Red de CÁNCER), Salamanca, Spain
| |
Collapse
|
9
|
Hirose EY, de Molla VC, Gonçalves MV, Pereira AD, Szor RS, da Fonseca ARBM, Fatobene G, Serpa MG, Xavier EM, Tucunduva L, Rocha V, Novis Y, Arrais-Rodrigues C. The impact of pretransplant malnutrition on allogeneic hematopoietic stem cell transplantation outcomes. Clin Nutr ESPEN 2019; 33:213-219. [PMID: 31451264 DOI: 10.1016/j.clnesp.2019.05.005] [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] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 05/01/2019] [Accepted: 05/06/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Malnutrition is a common finding in allogeneic hematopoietic stem cell transplantation (alloHSCT) patients, and there is some evidence that malnutrition might negatively affect the transplant outcomes. METHOD We performed a retrospective study with 148 patients aged 18-75 years, who underwent alloHSCT between 2011 and 2017. Patients were classified according to the body mass index (BMI) and the Subjective Global Assessment (SGA). The SGA was assessed on the day of hospitalization for the transplant, and classifies patients into three groups: A (well-nourished), B (moderately malnourished) and C (severely malnourished). RESULTS The SGA classified 49 (33%) patients as well-nourished, 54 (37%) as moderately malnourished, and 45 (30%) as severely malnourished. SGA-C was also associated with severe acute graft versus host disease (aGVHD) with a cumulative incidence (CI) of 31% vs. a CI of 14% for combined well-nourished or moderately malnourished group (SGA-A or -B, P = 0.017). In multivariate analysis, SGA-C compared to SGA-A or -B, remained as an independent risk factor for aGVHD (hazard ratio - HR 1.68, 95% confidence interval - 95% CI 1.02-2.74), and nonrelapse mortality (NRM - HR 3.63, 95% CI 1.76-7.46), worse progression free survival (HR 2.12, 95% CI 1.25-3.60), and worse overall survival (HR 3.27, 95% CI 1.90-5.64). CONCLUSION Malnutrition increases the risk of aGVHD and NRM and has a negative impact on survival.
Collapse
Affiliation(s)
- Erika Yuri Hirose
- Hospital Sírio Libanês, São Paulo, Brazil; Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Vinicius Campos de Molla
- Hospital Sírio Libanês, São Paulo, Brazil; Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo, São Paulo, Brazil.
| | | | - André Domingues Pereira
- Hospital Sírio Libanês, São Paulo, Brazil; Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Ana Rita Brito Medeiro da Fonseca
- Hospital Sírio Libanês, São Paulo, Brazil; Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | | | | | - Vanderson Rocha
- Hospital Sírio Libanês, São Paulo, Brazil; Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo/ICESP, São Paulo, Brazil; Churchill Hospital, NHS-BT, Oxford, United Kingdom
| | - Yana Novis
- Hospital Sírio Libanês, São Paulo, Brazil
| | - Celso Arrais-Rodrigues
- Hospital Sírio Libanês, São Paulo, Brazil; Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo, São Paulo, Brazil
| |
Collapse
|
10
|
Gonçalves MV, Rodrigues CA, Lorand Metze IGH, Lacerda MP, de Lourdes Lopes Ferrari Chauffaill M, Azevedo A, Machado C, Chiattone CS, Fortier S, Perobelli L, Ikoma MRV, Clementino N, Hamerschlak N, Sthel VM, Ommati LVM, de Farias DLC, Duarte FB, Buccheri V, de Azambuja AP, de Almeida DR, Figueiredo VLP, Yamamoto M. Chronic lymphocytic leukemia in Brazil: A retrospective analysis of 1903 cases. Am J Hematol 2017; 92:E171-E173. [PMID: 28474845 DOI: 10.1002/ajh.24779] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 05/01/2017] [Indexed: 11/05/2022]
Affiliation(s)
| | - Celso Arrais Rodrigues
- Universidade Federal de São Paulo (UNIFESP/EPM); São Paulo Brazil
- Hospital Sírio Libanês; São Paulo Brazil
| | | | | | | | | | | | - Carlos Sérgio Chiattone
- Santa Casa de Misericórdia de São Paulo; São Paulo Brazil
- Hospital Samaritano; São Paulo Brazil
| | - Sérgio Fortier
- Santa Casa de Misericórdia de São Paulo; São Paulo Brazil
| | - Leila Perobelli
- Hospital de Transplantes Euryclides de Jesus Zerbini/Hospital Brigadeiro; São Paulo Brazil
| | | | | | | | | | | | | | | | | | | | | | | | - Mihoko Yamamoto
- Universidade Federal de São Paulo (UNIFESP/EPM); São Paulo Brazil
| |
Collapse
|
11
|
Sandes AF, Gonçalves MV, Chauffaille MDL. Frequency of polycythemia in individuals with normal complete blood cell counts according to the new 2016 WHO classification of myeloid neoplasms. Int J Lab Hematol 2017; 39:528-531. [PMID: 28497563 DOI: 10.1111/ijlh.12686] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 02/15/2017] [Accepted: 03/21/2017] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Polycythemia vera (PV) is a disorder characterized by clonal proliferation of myeloid cells and increased red blood cell mass. Recently, the revised 2016 WHO classification of myeloid neoplasms decreased the threshold levels of hemoglobin and hematocrit for the diagnosis of PV. However, the new proposed cutoffs have remarkable overlap with the normal reference values reported and the clinical impact of these new cutoffs has not been widely assessed in the general population. METHODS We retrospectively examined 248 839 patients with presumptively normal complete blood cell results, consecutively obtained in an outpatient setting. RESULTS The proportion of men with Hb >165 g/L was 5.99%, Hct>49% was 2.4%, and Hb >165 g/dL or Hct>49% was 6.48%, while the proportion of women with Hb >160 g/L was 0.22%, Hct>48% was 0.11%, and Hb >160 g/L or Hct>48% was 0.28%. CONCLUSION The isolated use of the proposed Hb/Hct levels as a definer of polycythemia may lead to a substantial increase in unnecessary diagnostic tests. In cases with borderline levels of hemoglobin, the diagnostic workup of PV should only be indicated in the presence of clinical and/or laboratorial features associated with MPN.
Collapse
Affiliation(s)
- A F Sandes
- Division of Hematology, Fleury Group, São Paulo, Brazil
| | - M V Gonçalves
- Division of Hematology, Fleury Group, São Paulo, Brazil
| | | |
Collapse
|
12
|
Rodrigues CA, Gonçalves MV, Ikoma MRV, Lorand-Metze I, Pereira AD, Farias DLCD, Chauffaille MDLLF, Schaffel R, Ribeiro EFO, Rocha TSD, Buccheri V, Vasconcelos Y, Figueiredo VLDP, Chiattone CS, Yamamoto M. Erratum to "Diagnosis and treatment of chronic lymphocytic leukemia: Recommendations from the Brazilian Group of Chronic Lymphocytic Leukemia" [Rev Bras Hematol Hemoter. 2016;38(4):346-357]. Rev Bras Hematol Hemoter 2017; 39:93-94. [PMID: 28270360 PMCID: PMC5339400 DOI: 10.1016/j.bjhh.2017.01.002] [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: 11/27/2022] Open
Affiliation(s)
- Celso Arrais Rodrigues
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Hospital Sírio Libanês, São Paulo, SP, Brazil.
| | - Matheus Vescovi Gonçalves
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Fleury Medicina e Saúde, São Paulo, SP, Brazil
| | | | | | | | | | | | - Rony Schaffel
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | | | - Talita Silveira da Rocha
- A.C Camargo Cancer Center, São Paulo, SP, Brazil; Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Valeria Buccheri
- Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brazil
| | - Yuri Vasconcelos
- Instituto Goiano de Oncologia e Hematologia (INGOH), Goiânia, GO, Brazil
| | | | - Carlos Sérgio Chiattone
- Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil; Hospital Samaritano, São Paulo, SP, Brazil
| | - Mihoko Yamamoto
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | | |
Collapse
|
13
|
Loureiro AD, Gonçalves MV, Ikoma MRV, Silva MRR, Colleoni GWB, Chauffaille MDL, Yamamoto M. Plasma cell leukemia with t(11;14)(q13;q32) simulating lymphoplasmacytic lymphoma - a diagnostic challenge solved by flow cytometry. Rev Bras Hematol Hemoter 2016; 39:66-69. [PMID: 28270351 PMCID: PMC5339392 DOI: 10.1016/j.bjhh.2016.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 10/01/2016] [Accepted: 10/10/2016] [Indexed: 12/27/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Mihoko Yamamoto
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
| |
Collapse
|
14
|
Rodrigues CA, Gonçalves MV, Ikoma MRV, Lorand-Metze I, Pereira AD, Farias DLCD, Chauffaille MDLLF, Schaffel R, Ribeiro EFO, Rocha TSD, Buccheri V, Vasconcelos Y, Figueiredo VLDP, Chiattone CS, Yamamoto M. Diagnosis and treatment of chronic lymphocytic leukemia: recommendations from the Brazilian Group of Chronic Lymphocytic Leukemia. Rev Bras Hematol Hemoter 2016; 38:346-357. [PMID: 27863764 PMCID: PMC5119662 DOI: 10.1016/j.bjhh.2016.07.004] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 07/19/2016] [Indexed: 02/06/2023] Open
Abstract
Chronic lymphocytic leukemia is characterized by clonal proliferation and progressive accumulation of B-cell lymphocytes that typically express CD19+, CD5+ and CD23+. The lymphocytes usually infiltrate the bone marrow, peripheral blood, lymph nodes, and spleen. The diagnosis is established by immunophenotyping circulating B-lymphocytes, and prognosis is defined by two staging systems (Rai and Binet) established by physical examination and blood counts, as well as by several biological and genetic markers. In this update, we present the recommendations from the Brazilian Group of Chronic Lymphocytic Leukemia for the diagnosis and treatment of chronic lymphocytic leukemia. The following recommendations are based on an extensive literature review with the aim of contributing to more uniform patient care in Brazil and possibly in other countries with a similar social–economic profile.
Collapse
Affiliation(s)
- Celso Arrais Rodrigues
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Hospital Sírio Libanês, São Paulo, SP, Brazil.
| | - Matheus Vescovi Gonçalves
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Fleury Medicina e Saúde, São Paulo, SP, Brazil
| | | | | | | | | | | | - Rony Schaffel
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | | | - Talita Silveira da Rocha
- A.C Camargo Cancer Center, São Paulo, SP, Brazil; Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Valeria Buccheri
- Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brazil
| | - Yuri Vasconcelos
- Instituto Goiano de Oncologia e Hematologia (INGOH), Goiânia, GO, Brazil
| | | | - Carlos Sérgio Chiattone
- Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil; Hospital Samaritano, São Paulo, SP, Brazil
| | - Mihoko Yamamoto
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | | |
Collapse
|
15
|
Gonçalves MV, Yamamoto M, Kimura EYS, Colturato VAR, de Souza MP, Mauad M, Ikoma MV, Novis Y, Rocha V, Ginani VC, Wanderley de Oliveira Felix OM, Seber A, Kerbauy FR, Hamerschlak N, Orfao A, Rodrigues CA. Low Counts of Plasmacytoid Dendritic Cells after Engraftment Are Associated with High Early Mortality after Allogeneic Stem Cell Transplantation. Biol Blood Marrow Transplant 2015; 21:1223-9. [PMID: 25792371 DOI: 10.1016/j.bbmt.2015.03.010] [Citation(s) in RCA: 9] [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: 12/01/2014] [Accepted: 03/11/2015] [Indexed: 10/23/2022]
Abstract
Dendritic cells (DCs) are antigen-presenting cells that drive immune responses and tolerance and are divided in different subsets: myeloid DCs (mDCs: lineage-; HLA-DR+, 11c+), plasmacytoid dendritic cells (pDCs: HLA-DR+, CD123+), and monocyte-derived DCs (moDC: lineage-, 11c+, 16+). After hematopoietic stem cell transplantation (HSCT), low DC counts in the recipients' peripheral blood (PB) have been associated with worse outcomes, but the relevance of DC graft content remains unclear, and there are few data in the setting of unrelated donor HSCT. We evaluated the DC graft content and monitored DC recovery in PB from 111 HSCT recipients (median age, 17 years; range 1 to 74), who received bone marrow (46%), umbilical cord blood (32%), or PB (22%) from unrelated (81%) or related donors (19%). In 86 patients with sustained allogeneic recovery, patients with higher counts of all DC subsets (pDC, mDC, and moDC) 3 weeks after engraftment had lower incidence of nonrelapse mortality (NMR) and acute graft-versus-host disease (aGVHD) and better survival. pDC counts were associated with more striking results: patients with higher pDC counts had much lower incidences of NRM (3% versus 47%, P < .0001), lower incidence of aGVHD (24% versus 67%, P < .0001), and better overall survival (92% versus 45%, P < .0001). In contrast, higher pDC counts in the graft was associated with an increased risk of aGVHD (55% versus 26%, P = .02). Our results indicate that DC counts are closely correlated with HSCT outcomes and warrant further prospective evaluation and possible early therapeutic interventions to ameliorate severe aGVHD and decrease mortality.
Collapse
Affiliation(s)
| | - Mihoko Yamamoto
- Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | | | | | | | - Yana Novis
- Centro de Oncologia, Hospital Sírio Libanês, São Paulo, Brazil
| | - Vanderson Rocha
- Eurocord/Saint-Louis Hospital, Paris, France; Churchill Hospital, Oxford University Hospital, Oxford, United Kingdom
| | | | | | | | - Fabio Rodrigues Kerbauy
- Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo, São Paulo, Brazil; Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Alberto Orfao
- Centro de Investigación del Cáncer (CIC,I BMCC USAL-CSIC); Servicio General de Citometría, Departamento de Medicina, IBSAL, Universidad de Salamanca, Salamanca, Spain
| | - Celso Arrais Rodrigues
- Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo, São Paulo, Brazil; Centro de Oncologia, Hospital Sírio Libanês, São Paulo, Brazil
| |
Collapse
|