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Azambuja AP, Beltrame MP, Schluga YC, Justus JLP, Malvezzi M, Bonfim C, Pasquini R. ANALYSIS OF B-LYMPHOCYTE MATURATION KINETICS WITH A 10-COLOR BCP-ALL MINIMAL RESIDUAL DISEASE DETECTION TUBE BY FLOW CYTOMETRY: A COMPARISON OF REGENERATING BONE MARROW BEFORE AND AFTER HEMATOPOIETIC STEM CELL TRANSPLANTATION. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.974] [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: 11/07/2022] Open
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2
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Azambuja AP, Schluga YC, Justus JLP, Beltrame MP, Funke VAM, Bonfim C, Malvezzi M, Pasquini R. IMPLANTAÇÃO DA PESQUISA DE DOENÇA RESIDUAL MÍNIMA POR CITOMETRIA DE FLUXO DE ALTA SENSIBILIDADE NAS LEUCEMIAS AGUDAS EM UM CENTRO ÚNICO NO BRASIL. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.971] [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: 11/11/2022] Open
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Azambuja AP, Oliveira MM, Cruvinel L, Bovo P, Bittencourt MA, Pasquini R, Malvezzi M. ANALYSIS OF BASELINE CHARACTERISTICS, DISEASE BURDEN AND LONG-TERM FOLLOW-UP OF 167 PATIENTS WITH BRAZILIAN PAROXYSMAL NOCTURNAL HEMOGLOBINURIA - ANOTHER NATURAL HISTORY. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.056] [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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Funke VAM, Lima ACM, Hamerschlak N, Colturato V, Souza MP, Vigorito AC, Teixeira GM, Rocha VG, Mariano LCB, Lerner D, Barros GMN, Pasquini R, Paz AA, Neves HRA, Simioni AJ, Silva CC, Martins V, Voltarelli CL, Tan BC, Flowers ME. ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANT FOR MYELOFIBROSIS IN BRAZIL: FACING OUR CHALLENGES. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.418] [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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Silva LG, Menezes I, Gallucci MC, Sola CB, Setubal DC, Nabhan SK, Oliveira MM, Pasquini R, Funke VAM. ANÁLISE DOS NÍVEIS DE BCR-ABL COMO PREDITOR DE RECAÍDA APÓS TRANSPLANTE ALOGÊNICO DE CÉLULAS TRONCO HEMATOPOIÉTICAS (TCTH) EM LEUCEMIA MIELÓIDE CRÔNICA NA ERA DOS INIBIDORES DE TIROSINA-QUINASE (ITQ). Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.419] [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: 11/15/2022] Open
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Voltarelli C, Tan B, Costa L, Pasquini R, Funke V. SCOPULARIOSE INVASIVA EM PACIENTE IMUNOSSUPRIMIDO: RELATO DE CASO. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.10.491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Hughes TP, Leber B, Cervantes F, Spector N, Pasquini R, Clementino NCD, Schwarer AP, Dorlhiac-Llacer PE, Mahon FX, Rea D, Guerci-Bresler A, Kamel-Reid S, Bendit I, Acharya S, Glynos T, Dalal D, Branford S, Lipton JH. Sustained deep molecular responses in patients switched to nilotinib due to persistent BCR-ABL1 on imatinib: final ENESTcmr randomized trial results. Leukemia 2017; 31:2529-2531. [PMID: 28862704 PMCID: PMC5668492 DOI: 10.1038/leu.2017.247] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- T P Hughes
- Division of Haematology, SA Pathology and South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - B Leber
- Clinical Pathology, McMaster University, Hamilton, Ontario, Canada
| | - F Cervantes
- Department of Hematology, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - N Spector
- Departamento de Clínica Médica/FM, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - R Pasquini
- Division of Hematology and Medical Oncology, Federal University of Paraná, Curitiba, Brazil
| | | | - A P Schwarer
- Department of Hematology, Alfred Hospital, Melbourne, Victoria, Australia
| | | | - F-X Mahon
- Laboratoire Hématopoïèse Leucémique et Cible Thérapeutique, Inserm U1035, Université Victor Ségalen, Bordeaux, France
| | - D Rea
- Unité de Thérapie Cellulaire et Clinique Transfusionnelle, Service des Maladies du Sang et EA3518, Hôpital Saint-Louis, Paris, France
| | - A Guerci-Bresler
- Department of Hematology, Brabois Hospital, Vandoeuvre-lès-Nancy, Vandoeuvre, France
| | - S Kamel-Reid
- Clinical Laboratory Genetics, Genome Diagnostics, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada
| | - I Bendit
- Hematology Unit, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - S Acharya
- Novartis Healthcare Pvt Ltd, Hyderabad, India
| | - T Glynos
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - D Dalal
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - S Branford
- Leukaemia Unit, Centre for Cancer Biology, SA Pathology, University of South Australia and University of Adelaide, Adelaide, South Australia, Australia
| | - J H Lipton
- Blood and Marrow Transplant Service, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
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Vieira AG, Funke VAM, Nunes EC, Frare R, Pasquini R. Bronchiolitis obliterans in patients undergoing allogeneic hematopoietic SCT. Bone Marrow Transplant 2014; 49:812-7. [PMID: 24614836 DOI: 10.1038/bmt.2014.25] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 01/04/2014] [Accepted: 01/08/2014] [Indexed: 11/09/2022]
Abstract
Bronchiolitis obliterans (BO) is a severe pulmonary complication of allo-SCT. This study evaluated the incidence of BO in patients undergoing allo-SCT in Hospital Universitário da Universidade Federal do Paraná, risk factors for developing this complication and prognostic factors for those patients who developed this entity. The study included 1286 patients transplanted between 1979 and 2009 who survived for 100 days or more. We diagnosed 53 cases of BO. The cumulative incidence was 2.9% in 1 year and 3.7% in 3 years. Among patients with chronic GVHD, the cumulative incidence at the same intervals was 8.4% and 9.9%, respectively. The median time between transplantation and diagnosis of BO was 260 days (49-3877 days). In the multivariate analysis the risk factors for BO were female donor, older recipients and acute GVHD. The main prognostic factor was the severity of pulmonary impairment. Patients who developed BO earlier than 260 days had a worse prognosis than those who did so later. At least 80% of deaths were directly related to BO.
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Affiliation(s)
- A G Vieira
- Universidade Federal do Paraná, Curitiba, Brazil
| | - V A M Funke
- Universidade Federal do Paraná, Curitiba, Brazil
| | - E C Nunes
- Universidade Federal do Paraná, Curitiba, Brazil
| | - R Frare
- Universidade Federal do Paraná, Curitiba, Brazil
| | - R Pasquini
- Universidade Federal do Paraná, Curitiba, Brazil
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Thakar MS, Bonfim C, Sandmaier BM, O’Donnell P, Ribeiro L, Gooley T, Deeg HJ, Flowers ME, Pasquini R, Storb R, Woolfrey AE, Kiem HP. Cyclophosphamide-based in vivo T-cell depletion for HLA-haploidentical transplantation in Fanconi anemia. Pediatr Hematol Oncol 2012; 29:568-78. [PMID: 22839094 PMCID: PMC3622043 DOI: 10.3109/08880018.2012.708708] [Citation(s) in RCA: 16] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Allogeneic hematopoietic cell transplantation (HCT) is the only known cure for patients with Fanconi anemia (FA) who develop aplasia or leukemia. However, transplant regimens typically contain high-dose alkylators, which are poorly tolerated in FA patients. Furthermore, as many patients lack human leukocyte antigen (HLA)-matched family donors, alternative donors are used, which can increase the risk of both graft rejection and graft-versus-host disease (GVHD). To improve on these three concerns, we developed a multi-institutional clinical trial using a fludarabine (FLU)-based conditioning regimen with limited alkylators/low-dose radiation, HLA-haploidentical marrow, followed by reduced-dose cyclophosphamide (CY) to treat three FA patients with aplasia. All three patients engrafted with 100% donor CD3 chimerism at 1 month. One patient died early from disseminated toxoplasmosis infection. Of the two survivors, one had significant pretransplant co-morbidities and inadequate immunosuppression, and developed severe acute GVHD. The other patient had only mild acute and no chronic GVHD. With a follow-up of 2 and 3 years, respectively, both patients are doing well, are transfusion-independent, and maintain full donor chimerism. The patient with severe GVHD has resolving oral GVHD and good quality of life. We conclude that using low-intensity conditioning, HLA-haploidentical marrow, and reduced-dose CY for in vivo T-cell depletion can correct life-threatening aplasia in FA patients.
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Affiliation(s)
- MS Thakar
- Medical College of Wisconsin, Milwaukee, WI
| | - C Bonfim
- Hospital de Clinicas, Universidade do Parana, Curitiba Brazil
| | - BM Sandmaier
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | - P O’Donnell
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | - L Ribeiro
- Hospital de Clinicas, Universidade do Parana, Curitiba Brazil
| | - T Gooley
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | - HJ Deeg
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | - ME Flowers
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | - R Pasquini
- Hospital de Clinicas, Universidade do Parana, Curitiba Brazil
| | - R Storb
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | - AE Woolfrey
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | - HP Kiem
- Fred Hutchinson Cancer Research Center, Seattle, WA
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Angeli G, Pasquini R, Panella V, Pelli MA. An epidemiologic survey of celiac disease in the Terni area (Umbria, Italy) in 2002-2010. J Prev Med Hyg 2012; 53:20-23. [PMID: 22803315] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The present work is an epidemiology survey of celiac disease in the province of Terni (Umbria, Italy) in 2002-2010. Data were collected from the Local Health Unit (LHU) 4 (ASL 4), Terni database and were extrapolated from the overall population of 232,540 (as of 2010) by identifying residents with prescription charge exemptions for celiac disease-oriented drugs. Prevalence and incidence analysis over the timeframe being examined showed that prevalence (330 cases in 2010) has consistently been increasing from 2002 to 2010, whereas incidence has remained essentially the same with minor, yearly fluctuations. Both prevalence and incidence were higher in females than in males. Most patients were diagnosed as young adults, with the highest rates in the 10-14, 35-40 and 55-60 age groups. Thus, in the area of investigation, there is evidence for consistent delayed diagnosis, raising the possibility that the atypical form the disease, more difficult to recognize and more likely to escape early diagnosis, may have become increasingly commoner overtime. Because the current prevalence of the disease in the Terni area is estimated to approximate 1%, the anticipated number of cases should amount to 2325, which value contrasts with the currently reported 330 diagnoses. It is suggested that the current illness-defining criteria should be revised so to implement early diagnosis and improve the patients' quality of life and access to treatment.
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Affiliation(s)
- G Angeli
- Department of Medical and Surgical Specialities and Public Health University of Perugia, Italy.
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11
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Bonfim C, Ribeiro L, Loth G, Bitencourt M, Kanaan S, Koliski A, Funke V, Pilonetto D, Zanis-Neto J, Pasquini R. Unrelated Bone Marrow Transplantation (UBMT) for Children and Adolescents with Fanconi Anemia (FA) Using Cyclophophamide, Fludarabine and Rabbit ATG: Analysis of 33 Patients Transplanted at a Single Institution. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.079] [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: 10/14/2022]
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12
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Larson RA, Kim D, Rosti G, Stenke L, Pasquini R, Hoenekopp A, Blakesley RE, Gallagher NJ, Hochhaus A, Hughes TP, Saglio G, Kantarjian H. Comparison of nilotinib and imatinib in patients (pts) with newly diagnosed chronic myeloid leukemia in chronic phase (CML-CP): ENESTnd 24-month follow-up. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.6511] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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13
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Nunes E, Funke V, Nabhan S, Vieira A, Sola C, Ribeiro L, Loth G, Setubal D, Bitencourt M, Bonfim C, Medeiros L, Oliveira M, Franco V, Pasquini R, Zanis Neto J. Secondary Malignancy After Allogeneic Hematopoietic Stem Cell Transplantation (HSCT): 30 Years Experience From a Single Center. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.264] [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: 10/18/2022]
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14
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Vasconcelos R, Fortier S, Cunha C, Piazzera F, Morando J, Bitencourt M, Pasquini R, Zanis Neto J, Funke V, Bonfim C. Toxoplasma Gondii Infection In 34 pts Submitted To Hematopoietic Stem Cell Transplantation: Analysis From A Single Institution. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.356] [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: 12/01/2022]
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15
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Nunes E, Funke V, Setubal D, Medeiros L, Oliveira M, Bonamin C, Nabhan S, Bitencourt M, Ribeiro L, Morando J, Bonfim C, Vieira A, Franco V, Loth G, Pasquini R, Neto J. Mycophenolate Mofetil As Therapy For Steroid Dependent Or Refractory Graft Versus Host Disease: Ten Years Experience From A Single Center In Brazil. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.464] [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: 11/24/2022]
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16
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Franco V, Funke V, Nunes E, Setubal D, Medeiros L, Michels M, Bonamin C, Nabhan S, Ribeiro L, Morando J, Bitencourt M, Bonfim C, Vieira A, Loth G, Pasquini R, Neto J. Extracorporeal Photopheresis In Refractory Acute And/Or Chronic Graft Versus Host Disease After Allogeneic Stem Cell Transplantation. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.465] [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: 11/29/2022]
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Beltrame MP, Malvezzi M, Zanis J, Pasquini R. Flow cytometry as a tool in the diagnosis of Bernard-Soulier Syndrome in Brazilian patients. Platelets 2009; 20:229-34. [DOI: 10.1080/09537100902893784] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pilonetto D, Pereira N, Bitencourt M, Magdalena N, Vieira E, Veiga L, Cavalli I, Ribeiro R, Pasquini R. FANCD2 Western blot as a diagnostic tool for Brazilian patients with Fanconi anemia. Braz J Med Biol Res 2009; 42:237-43. [DOI: 10.1590/s0100-879x2009000300004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2008] [Accepted: 01/20/2009] [Indexed: 11/21/2022] Open
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Bittencourt H, Funke V, Fogliatto L, Magalhães S, Setubal D, Paz A, Macedo AV, Ruiz J, Azambuja AP, Silla L, Clementino N, Pasquini R. Imatinib mesylate versus allogeneic BMT for patients with chronic myeloid leukemia in first chronic phase. Bone Marrow Transplant 2008; 42:597-600. [DOI: 10.1038/bmt.2008.218] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Moura GL, Pasquini R, Padilha S, Vianna K, Albini L. Gemcitabine and cisplatin chemotherapy in the treatment of platinum-resistant ovarian and peritoneal carcinoma. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16563] [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: 11/20/2022] Open
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21
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Hungria VT, Maiolino A, Martinez G, Colleoni GW, Coelho EO, Rocha L, Nunes R, Bittencourt R, Oliveira LC, Faria RMO, Pasquini R, Magalhaes SM, Souza CA, Pinto Neto JV, Barreto L, Andrade E, Portella MDSO, Bolejack V, Durie BG. Confirmation of the utility of the International Staging System and identification of a unique pattern of disease in Brazilian patients with multiple myeloma. Haematologica 2008; 93:791-2. [DOI: 10.3324/haematol.11637] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Bonfim C, Koliski A, Bitencourt M, Quiroga M, Setubal D, Funke V, Ruiz J, Medeiros L, Oliveira M, Coutinho E, Zanis Neto J, de Medeiros C, Pasquini R. 215: Hematopoietic Stem Cell Transplantation (HSCT) in Wiskott Aldrich Syndrome (WAS): A Single Center Experience in 25 Patients. Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.224] [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: 11/26/2022]
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Funke V, Nunes E, Medeiros L, Setubal D, Ruiz J, Oliveira M, Bittencourt M, Bonfim C, Neto J, Medeiros C, Pasquini R. 387: Effect of Acute and Chronic GVHD on Overall Survival in 122 Unrelated Transplants for Malignant Diseases Performed Over Ten Years in a Single Center in Brazil. Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.397] [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: 10/22/2022]
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Villarini M, Moretti M, Fatigoni C, Agea E, Dominici L, Mattioli A, Volpi R, Pasquini R. Evaluation of primary DNA damage, cytogenetic biomarkers and genetic polymorphisms for CYP1A1 and GSTM1 in road tunnel construction workers. J Toxicol Environ Health A 2008; 71:1430-1439. [PMID: 18800292 DOI: 10.1080/15287390802328580] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
In tunnel construction workers, occupational exposure to dust (alpha-quartz and other particles from blasting), gases (nitrogen dioxide, NO(2)), diesel exhausts, and oil mist has been associated with lung function decline, induction of inflammatory reactions in the lungs with release of mediators that may influence blood coagulation, and increased risk of chronic obstructive pulmonary disease. The present molecular epidemiology study was designed to evaluate whether occupational exposure to indoor pollutants during road tunnel construction might result in genotoxic effects. A study group of 39 underground workers and a reference group of 34 unexposed subjects were examined. Primary and oxidative DNA damage, sister-chromatid exchanges (SCE), and micronuclei (MN) were measured in peripheral blood cells. The possible influences of polymorphisms in gene encoding for CYP1A1 and GSTM1 xenobiotic-metabolizing enzymes were also investigated. Exposure assessment was performed with detailed interviews and questionnaires. There were no significant differences in the level of primary and oxidative DNA damage and frequency of SCE between the tunnel workers and controls, whereas the frequency of MN showed a significant increase in exposed subjects compared to controls. No effects of CYP1A1 or GSTM1 variants were observed for the analyzed biomarkers. Since MN in peripheral blood lymphocytes are recognized as a predictive biomarker of cancer risk within a population of healthy subjects, the genotoxic risk of occupational exposure to various indoor environmental pollutants during road tunnel construction cannot be excluded by this biomonitoring study.
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Affiliation(s)
- M Villarini
- Dipartimento di Specialità Medico-Chirurgiche e Sanità Pubblica, Università degli Studi di Perugia, Perugia
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Teive HAG, Carsten ALM, Iwamoto FM, Almeida SM, Munhoz RP, Werneck LC, Medeiros CR, Pasquini R. Fungal encephalitis following bone marrow transplantation: Clinical findings and prognosis. J Postgrad Med 2008; 54:203-5. [DOI: 10.4103/0022-3859.41802] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Baruque GA, Bitencourt MA, Pasquini R, Castelo-Branco MTL, Llerena JC, Rumjanek VM. Bax expression and apoptotic cell death in Fanconi anaemia peripheral blood lymphocytes. Cell Prolif 2007; 40:558-67. [PMID: 17635522 PMCID: PMC6495656 DOI: 10.1111/j.1365-2184.2007.00446.x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Deregulated apoptosis might be involved in some of the features of Fanconi anaemia (FA). The possibility that the pro-apoptotic Bax protein could be involved in an increased susceptibility to apoptosis in FA patients was investigated. MATERIALS AND METHODS Intracellular Bax expression, Bcl-2 expression (an anti-apoptotic protein) and cell death were analysed in 26 FA peripheral blood lymphocyte samples. RESULTS Most FA samples (69%) displayed increased levels of Bax and were more susceptible to both spontaneous apoptosis and mitogen activation-induced cell death. Two subgroups were identified: one presented elevated levels of Bax (n = 18), whereas the other (n = 8), had Bax levels lower than controls. Two subgroups based on Bcl-2 expression were also identified: one with normal and another with high Bcl-2 expression. No inverse correlation was found between Bcl-2 levels and Bax expression. A clear difference in susceptibility to induced cell death could be observed between control and FA samples. The best correlation was observed between high levels of Bax and mitogen-induced apoptosis of cells; these displayed characteristics of necrosis secondary to apoptosis, suggesting that the intrinsic apoptotic pathway was being activated. CONCLUSION Despite increased susceptibility to cell death induction, there was no correlation between Bax levels, chromosome breakage, haematological parameters or androgen therapy. The importance of apoptosis and Bax expression in the clinical development of FA awaits clarification.
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Affiliation(s)
- G A Baruque
- Instituto de Bioquímica Médica/CCS - UFRJ, and Instituto de Biofísica Carlos Chagas Filho/CCS - UFRJ, Rio de Janeiro, Brazil
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Pasquini R, Ottmann OG, Goh YT, Kim D, Dorlhiac Llacer PE, DiPersio JF, Khoury HJ, Van Tornout JM, Damokosh A, Kantarjian HM. Dasatinib 140 mg QD compared to 70 mg BID in advanced-phase CML or Ph(+) ALL resistant or intolerant to imatinib: One-year results of CA180–035. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.7025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7025 Background: Dasatinib, an oral multi-targeted kinase inhibitor of BCR-ABL and SRC family kinases, has been shown to be safe and effective at 70 mg BID in advanced phase CML and Ph(+) ALL resistant or intolerant to imatinib. QD and BID schedules were equipotent in Phase I which led to this dose-optimization study. Methods: In this Phase-III, open-label, prospective study, patients with imatinib-resistant or intolerant advanced phase CML or Ph(+) ALL were randomized to dasatinib 140 mg QD or 70 mg BID. The primary objective compared the major hematologic response (HR) rate between the 2 regimens. Dose escalation was allowed for inadequate response and dose reduction for drug toxicity. Results: From June 2005 through March 2006, 611 patients (56% male) were randomized (median age 55 years). 42% of patients received imatinib at doses >600 mg/d and 37% were treated for >3 y. Response rates, with a median follow-up of 6.5 mo (range <1 to 17 mo), are summarized in the table below. Median durations of HR and progression-free survival were 10.2 and 7.9 mo for the 140-mg QD regimen vs 12.3 and 11.7 mo in the 70-mg BID arm. Drug-related toxicities in 140-mg QD (n=304) vs 70-mg BID (n=305) arms, respectively, listed as all grades (grade 3–4), were: pleural effusion 16% vs 23%, P=0.024 (5% vs 6%); peripheral edema 6% vs 13%, P=0.004 (<1%/1%); pericardial effusion <1% vs 4%, P=0.012 (0% vs 1%); neutropenia 85% vs 87% (65% vs 70%); thrombocytopenia 89% vs 92% (68% vs 70%). Dose reductions (24% vs 36%, P=0.002) and interruptions (47% vs 54%, P=0.105) were required less frequently for the 140-mg QD regimen, whereas dose escalations were more prevalent (33% vs 22%, P=0.005). Conclusions: Dasatinib 140 mg QD shows comparable hematologic and cytogenetic response and a trend for improved tolerability in relation to 70 mg BID. Further follow-up is ongoing to assess the long-term benefit of these two schedules in patients with ABP-CML or Ph(+) ALL; 1-year follow-up will be presented. [Table: see text] [Table: see text]
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Affiliation(s)
- R. Pasquini
- Hospital De Clinicas De Curitiba, Curitiba, Brazil; Johann Wolfgang Goethe Universitaet, Frankfurt, Germany; Singapore General Hospital, Singapore, Singapore; St Mary's Hospital, Seoul, Republic of Korea; Hospital das Clinicas, Sao Paulo, Brazil; Washington University School of Medicine, St. Louis, MO; Emory University School of Medicine, Atlanta, GA; Bristol-Myers Squibb, Wallingford, CT; MD Anderson Cancer Center, Houston, TX
| | - O. G. Ottmann
- Hospital De Clinicas De Curitiba, Curitiba, Brazil; Johann Wolfgang Goethe Universitaet, Frankfurt, Germany; Singapore General Hospital, Singapore, Singapore; St Mary's Hospital, Seoul, Republic of Korea; Hospital das Clinicas, Sao Paulo, Brazil; Washington University School of Medicine, St. Louis, MO; Emory University School of Medicine, Atlanta, GA; Bristol-Myers Squibb, Wallingford, CT; MD Anderson Cancer Center, Houston, TX
| | - Y. T. Goh
- Hospital De Clinicas De Curitiba, Curitiba, Brazil; Johann Wolfgang Goethe Universitaet, Frankfurt, Germany; Singapore General Hospital, Singapore, Singapore; St Mary's Hospital, Seoul, Republic of Korea; Hospital das Clinicas, Sao Paulo, Brazil; Washington University School of Medicine, St. Louis, MO; Emory University School of Medicine, Atlanta, GA; Bristol-Myers Squibb, Wallingford, CT; MD Anderson Cancer Center, Houston, TX
| | - D. Kim
- Hospital De Clinicas De Curitiba, Curitiba, Brazil; Johann Wolfgang Goethe Universitaet, Frankfurt, Germany; Singapore General Hospital, Singapore, Singapore; St Mary's Hospital, Seoul, Republic of Korea; Hospital das Clinicas, Sao Paulo, Brazil; Washington University School of Medicine, St. Louis, MO; Emory University School of Medicine, Atlanta, GA; Bristol-Myers Squibb, Wallingford, CT; MD Anderson Cancer Center, Houston, TX
| | - P. E. Dorlhiac Llacer
- Hospital De Clinicas De Curitiba, Curitiba, Brazil; Johann Wolfgang Goethe Universitaet, Frankfurt, Germany; Singapore General Hospital, Singapore, Singapore; St Mary's Hospital, Seoul, Republic of Korea; Hospital das Clinicas, Sao Paulo, Brazil; Washington University School of Medicine, St. Louis, MO; Emory University School of Medicine, Atlanta, GA; Bristol-Myers Squibb, Wallingford, CT; MD Anderson Cancer Center, Houston, TX
| | - J. F. DiPersio
- Hospital De Clinicas De Curitiba, Curitiba, Brazil; Johann Wolfgang Goethe Universitaet, Frankfurt, Germany; Singapore General Hospital, Singapore, Singapore; St Mary's Hospital, Seoul, Republic of Korea; Hospital das Clinicas, Sao Paulo, Brazil; Washington University School of Medicine, St. Louis, MO; Emory University School of Medicine, Atlanta, GA; Bristol-Myers Squibb, Wallingford, CT; MD Anderson Cancer Center, Houston, TX
| | - H. J. Khoury
- Hospital De Clinicas De Curitiba, Curitiba, Brazil; Johann Wolfgang Goethe Universitaet, Frankfurt, Germany; Singapore General Hospital, Singapore, Singapore; St Mary's Hospital, Seoul, Republic of Korea; Hospital das Clinicas, Sao Paulo, Brazil; Washington University School of Medicine, St. Louis, MO; Emory University School of Medicine, Atlanta, GA; Bristol-Myers Squibb, Wallingford, CT; MD Anderson Cancer Center, Houston, TX
| | - J. M. Van Tornout
- Hospital De Clinicas De Curitiba, Curitiba, Brazil; Johann Wolfgang Goethe Universitaet, Frankfurt, Germany; Singapore General Hospital, Singapore, Singapore; St Mary's Hospital, Seoul, Republic of Korea; Hospital das Clinicas, Sao Paulo, Brazil; Washington University School of Medicine, St. Louis, MO; Emory University School of Medicine, Atlanta, GA; Bristol-Myers Squibb, Wallingford, CT; MD Anderson Cancer Center, Houston, TX
| | - A. Damokosh
- Hospital De Clinicas De Curitiba, Curitiba, Brazil; Johann Wolfgang Goethe Universitaet, Frankfurt, Germany; Singapore General Hospital, Singapore, Singapore; St Mary's Hospital, Seoul, Republic of Korea; Hospital das Clinicas, Sao Paulo, Brazil; Washington University School of Medicine, St. Louis, MO; Emory University School of Medicine, Atlanta, GA; Bristol-Myers Squibb, Wallingford, CT; MD Anderson Cancer Center, Houston, TX
| | - H. M. Kantarjian
- Hospital De Clinicas De Curitiba, Curitiba, Brazil; Johann Wolfgang Goethe Universitaet, Frankfurt, Germany; Singapore General Hospital, Singapore, Singapore; St Mary's Hospital, Seoul, Republic of Korea; Hospital das Clinicas, Sao Paulo, Brazil; Washington University School of Medicine, St. Louis, MO; Emory University School of Medicine, Atlanta, GA; Bristol-Myers Squibb, Wallingford, CT; MD Anderson Cancer Center, Houston, TX
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Abstract
1084 Background: Gemcitabine plus cisplatin have synergistic activity and have been tested in several schedules and doses in metastatic breast cancer. Our objectives were to assesss the efficacy and toxicity of gemcitabine and cisplatin in pretreated patients. Methods: Measurable disease and at least two prior anthracycline and /or taxane-containing regimen in either metastatic or adjuvant setting was required. Treatment consisted of gemcitabine 700mg/m(2) IV infusion over 30 min plus cisplatin 30mg(2) given on day1 and 8 every 3 weeks. Results: Seventy four patients with median age of 48 years (range 26- 73) were recruited. A median of six cycles of the study treatment was delivered. The overal response rate was 30% (95% confidence interval, 12–53%). Median time to progreesion was 30.6 weeks (95%CI, 12.6–44 weeks). Median survival was 73.2 weeks (95% CI, 47.1–93.2 weeks). Toxicities included grade 3 and 4 leukopenia in 27(36.4%), anemia in 19 (25.6%) and oral mucositis in 4 (5.4%). No grade 3 or 4 peripheral neurophaty, hepatic or renal dysfunction was observed. No treatment-related death ocurred. Conclusions: Gemcitabine plus cisplatin is a well tollerated and active treatment in heavily pretreated patients with metastatic breast cancer. No significant financial relationships to disclose.
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Affiliation(s)
| | | | - A. Frare
- Hospital De Clinicas, Parana, Brazil
| | - K. Vianna
- Hospital De Clinicas, Parana, Brazil
| | - L. Albini
- Hospital De Clinicas, Parana, Brazil
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Oliveira AL, de Souza M, Carvalho-Dias VMH, Ruiz MA, Silla L, Tanaka PY, Simões BP, Trabasso P, Seber A, Lotfi CJ, Zanichelli MA, Araujo VR, Godoy C, Maiolino A, Urakawa P, Cunha CA, de Souza CA, Pasquini R, Nucci M. Epidemiology of bacteremia and factors associated with multi-drug-resistant gram-negative bacteremia in hematopoietic stem cell transplant recipients. Bone Marrow Transplant 2007; 39:775-81. [PMID: 17438585 DOI: 10.1038/sj.bmt.1705677] [Citation(s) in RCA: 130] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The incidence of Gram-negative bacteremia has increased in hematopoietic stem cell transplant (HSCT) recipients. We prospectively collected data from 13 Brazilian HSCT centers to characterize the epidemiology of bacteremia occurring early post transplant, and to identify factors associated with infection due to multi-drug-resistant (MDR) Gram-negative isolates. MDR was defined as an isolate with resistance to at least two of the following: third- or fourth-generation cephalosporins, carbapenems or piperacillin-tazobactam. Among 411 HSCT, fever occurred in 333, and 91 developed bacteremia (118 isolates): 47% owing to Gram-positive, 37% owing to Gram-negative, and 16% caused by Gram-positive and Gram-negative bacteria. Pseudomonas aeruginosa (22%), Klebsiella pneumoniae (19%) and Escherichia coli (17%) accounted for the majority of Gram-negative isolates, and 37% were MDR. These isolates were recovered from 20 patients, representing 5% of all 411 HSCT and 22% of the episodes with bacteremia. By multivariate analysis, treatment with third-generation cephalosporins (odds ratio (OR) 10.65, 95% confidence interval (CI) 3.75-30.27) and being at one of the hospitals (OR 9.47, 95% CI 2.60-34.40) were associated with infection due to MDR Gram-negative isolates. These findings may have important clinical implications in the decision of giving prophylaxis and selecting the empiric antibiotic regimen.
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Affiliation(s)
- A L Oliveira
- Hospital Universitário, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Funke V, Coutinho E, Setubal D, Ruiz J, Bonfim C, Bittencourt M, Oliveira M, Zanis-Neto J, de Medeiros C, Pasquini R. 238: Risk factor analisis for survival in 125 unrelated transplants for malignant diseases performed over ten years in a single center in Brazil. Biol Blood Marrow Transplant 2007. [DOI: 10.1016/j.bbmt.2006.12.243] [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: 10/23/2022]
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31
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Funke V, Pettengill C, Bonfim C, Ruiz J, Azambuja A, Medeiros L, Setubal D, Bitencourt M, Oliveira M, Coutinho E, Zanis-neto J, de Medeiros C, Pasquini R. 237: Long term results of allogeneic stem cell transplant for CML in pediatric patients. Biol Blood Marrow Transplant 2007. [DOI: 10.1016/j.bbmt.2006.12.242] [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: 11/24/2022]
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32
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Setubal D, Medeiros C, Bitencourt M, Bonfim C, Funke V, Zanis J, Cesario E, Carvalho D, Nunes E, Oliveira M, Pasquini R. 271: Umbilical cord blood transplantation – report of 106 cases from a single Brazilian institution. Biol Blood Marrow Transplant 2007. [DOI: 10.1016/j.bbmt.2006.12.276] [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: 11/24/2022]
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33
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Bonfim C, Bitencourt M, Setubal D, Funke V, Ruiz J, Oliveira M, Coutinho E, deMedeiros C, Zanis-Neto J, Pasquini R. 65: The use of cyclophosphamide (CY), fludarabine and ATG as a preparative regimen for unrelated cord blood transplantation (UCBT) in fanconi anemia. Biol Blood Marrow Transplant 2007. [DOI: 10.1016/j.bbmt.2006.12.068] [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]
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de Medeiros CR, Bitencourt MA, Zanis-Neto J, Maluf ECP, Carvalho DS, Bonfim CS, Funke VM, Setubal DC, Farah N, Pasquini R. Allogeneic hematopoietic stem cell transplantation from an alternative stem cell source in Fanconi anemia patients: analysis of 47 patients from a single institution. Braz J Med Biol Res 2006; 39:1297-304. [PMID: 17053839 DOI: 10.1590/s0100-879x2006001000005] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2005] [Accepted: 07/07/2006] [Indexed: 11/22/2022] Open
Abstract
We transplanted 47 patients with Fanconi anemia using an alternative source of hematopoietic cells. The patients were assigned to the following groups: group 1, unrelated bone marrow (N = 15); group 2, unrelated cord blood (N = 17), and group 3, related non-sibling bone marrow (N = 15). Twenty-four patients (51%) had complete engraftment, which was not influenced by gender (P = 0.87), age (P = 0.45), dose of cyclophosphamide (P = 0.80), nucleated cell dose infused (P = 0.60), or use of anti-T serotherapy (P = 0.20). Favorable factors for superior engraftment were full HLA compatibility (independent of the source of cells; P = 0.007) and use of a fludarabine-based conditioning regimen (P = 0.046). Unfavorable factors were > or = 25 transfusions pre-transplant (P = 0.011) and degree of HLA disparity (P = 0.007). Intensity of mucositis (P = 0.50) and use of androgen prior to transplant had no influence on survival (P = 0.80). Acute graft-versus-host disease (GVHD) grade II-IV and chronic GVHD were diagnosed in 47 and 23% of available patients, respectively, and infections prevailed as the main cause of death, associated or not with GVHD. Eighteen patients are alive, the Kaplan-Meyer overall survival is 38% at approximately 8 years, and the best results were obtained with related non-sibling bone marrow patients. Three recommendations emerged from the present study: fludarabine as part of conditioning, transplant in patients with < 25 transfusions and avoidance of HLA disparity. In addition, an extended family search (even when consanguinity is not present) seeking for a related non-sibling donor is highly recommended.
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Affiliation(s)
- C R de Medeiros
- Serviço de Transplante de Medula Ossea, Hospital de Clínicas, Universidade Federal do Paraná, Rua General Carneiro 181, 80060-900 Curitiba, PR, Brazil.
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Medeiros CD, Bitencourt M, Zanis-Neto J, Maluf E, Carvalho D, Bonfim C, Funke V, Setubal D, Farah N, Pasquini R. Allogeneic hematopoietic stem cell transplantation from an alternative stem cell source in Fanconi anemia patients: analysis of 47 patients from a single institution. Braz J Med Biol Res 2006. [DOI: 10.1590/s0100-879x2006005000013] [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: 11/22/2022] Open
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Moura GL, Giublin M, Albini L, Pasquini R, Viana K, Chicoski F. Effectiveness,safety and tolerability of codeine in cancer patients. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.18577] [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] [Indexed: 11/20/2022] Open
Abstract
18577 Background: In 1984 WHO guidelines for cancer pain was proposed. Codeine was selected among several others drugs when pain ladder step II was required. Since then very few comparative studies have been performed. Codein is a weak opioid and its analgesic action is not completely understood. A possible conversion into morphine is postulated. To determine efficacy, safety and tolerability of codein in advanced cancer patient we designed a prospective cohort study. Methods 150 metastatic cancer patients were studied during six months. A standard zero to then table scale for pain rating was used. The malignacies were: prostate 15 (10%), breast 42 (28%), lung 33 (22%), colon 37 (24.6%), other cancer 23 (15.3%). 62 patients were under treatment (41.3%). Results: There were: 83 M (55.3%) 67 F(44,7%) and the mean age was 62 years. Mean initial and final pain score were 7.1 and 1.3 respectively. Codein dose range from 30 mg/day to 270 mg/day (mean dose 180 mg/day). The average time of use was 13,7 months. Severe toxicity was 0% and the most often side effect was constipation (38.7%). Adjuvant drugs were used in 97 patients (64.7%) of patients. Uncontrolled pain ocurred in 17 patients (11.3%). Conclusions: During the last decade a great increase in the range of opioid agents and formulations available have emerged. Codein still represents an excellent drug for patients with long life expectancy. Side effects are manageable and are mainly constipation. Pain control was achieved in the majority of patients. Codein showed a low toxicity profile with a high compliance rate. Economic reasons must be strongly consider in poor countries and codein represents a good alternative option. Future comparative studies addressing also quality of life should be performed. No significant financial relationships to disclose.
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Affiliation(s)
| | | | - L. Albini
- Hospital de Clinicas, Curitiba, Brazil
| | | | - K. Viana
- Hospital de Clinicas, Curitiba, Brazil
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Shah NP, Rousselot P, Pasquini R, Hamerschlak N, Holowiecki J, Gerard B, Dejardin D, Kantarjian H. Dasatinib (D) vs high dose imatinib (IM) in patients (pts) with chronic phase chronic myeloid leukemia (CP-CML) resistant to imatinib. Results of CA180017 START-R randomized trial. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.6507] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6507 Background: High dose imatinib (800 mg/day) has been shown to have efficacy in a subset of CML patients with resistance to IM, although the durability of responses is not well-established. Dasatinib (BMS-354825) is a novel, highly potent, oral multi-targeted kinase inhibitor of BCR-ABL and SRC with activity against 18/19 imatinib resistant BCR-ABL mutants tested in vitro. Methods: START-R is a multicenter randomized (2:1 ratio) trial of D 70 mg twice daily (bid) and IM 800 mg/day in pts with CP-CML resistant to prior IM 400 to 600 mg/day. Cross-over was allowed for lack of response or intolerance (grade 3–4 non hematologic toxicity). D dose escalation to 90 mg bid was allowed for inadequate response at 12 wks, and dose reduction to 50 or 40 mg bid for drug toxicity. IM dose reduction to 600 mg/day was allowed. Evaluations consisted of weekly blood counts for the first 12 wks, bone marrow cytology and cytogenetics every 12 wks. The primary endpoint was major cytogenetic response (MCyR) rate at wk 12. Results: From February 2005 to November 2005, 150 pts were randomized of whom the first 36 pts (D 22, IM 14) are reported. Median age was 57 yrs, with 12 males and 24 females. Treatment groups were balanced with respect to CML characteristics; median time from initial diagnosis was 61 months for D and IM; prior interferon 64% and 79%; no prior CyR on IM 36% and 57%. BCR-ABL mutations were documented in 10 D pts and 1 IM pt. Dose reductions were required in 8 D pts and 1 IM pt. Complete hematologic response was documented in 21 D and 13 IM pts. MCyR rate at 12 wks was 45% for D and 21% for IM (7 complete for D and 1 for IM). With a 95% CI on the difference between D and IM was - 9.9 to +51.2. Two (9%) D and 11 (79%) IM pts crossed over for intolerance (1 D and 6 IM) or no MCyR (1 D and 5 IM). Grade 3–4 neutropenia or thrombopenia occurred in 8 and 9 dasatinib pts and in 8 and 2 IM pts. Most common grade 1–2 non-hematologic toxicities in D and IM groups were diarrhea (7 and 1 pts), nausea (7 and 7 pts), and facial/peripheral edema (8 and 7 pts). Conclusions: Dasatinib was effective in pts with CP-CML resistant to IM 400 to 600 mg/day. Preliminary data suggest that D is more effective and better tolerated than high dose IM. An updated analysis of all randomized pts will be presented. [Table: see text]
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Affiliation(s)
- N. P. Shah
- University of California at Los Angeles School of Medicine, Los Angeles, CA; Centre Hospitalier Saint Louis, Paris, France; Hospital de Clinicas de Curitiba, Parana, Brazil; Hospital Israelita Albert Einstein, Sao Paulo, Brazil; Katedra I Klinika Hematologii I, Katowice, Poland; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Braine-l’Alleud, Belgium; UT M. D. Anderson Cancer Center, Houston, TX
| | - P. Rousselot
- University of California at Los Angeles School of Medicine, Los Angeles, CA; Centre Hospitalier Saint Louis, Paris, France; Hospital de Clinicas de Curitiba, Parana, Brazil; Hospital Israelita Albert Einstein, Sao Paulo, Brazil; Katedra I Klinika Hematologii I, Katowice, Poland; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Braine-l’Alleud, Belgium; UT M. D. Anderson Cancer Center, Houston, TX
| | - R. Pasquini
- University of California at Los Angeles School of Medicine, Los Angeles, CA; Centre Hospitalier Saint Louis, Paris, France; Hospital de Clinicas de Curitiba, Parana, Brazil; Hospital Israelita Albert Einstein, Sao Paulo, Brazil; Katedra I Klinika Hematologii I, Katowice, Poland; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Braine-l’Alleud, Belgium; UT M. D. Anderson Cancer Center, Houston, TX
| | - N. Hamerschlak
- University of California at Los Angeles School of Medicine, Los Angeles, CA; Centre Hospitalier Saint Louis, Paris, France; Hospital de Clinicas de Curitiba, Parana, Brazil; Hospital Israelita Albert Einstein, Sao Paulo, Brazil; Katedra I Klinika Hematologii I, Katowice, Poland; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Braine-l’Alleud, Belgium; UT M. D. Anderson Cancer Center, Houston, TX
| | - J. Holowiecki
- University of California at Los Angeles School of Medicine, Los Angeles, CA; Centre Hospitalier Saint Louis, Paris, France; Hospital de Clinicas de Curitiba, Parana, Brazil; Hospital Israelita Albert Einstein, Sao Paulo, Brazil; Katedra I Klinika Hematologii I, Katowice, Poland; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Braine-l’Alleud, Belgium; UT M. D. Anderson Cancer Center, Houston, TX
| | - B. Gerard
- University of California at Los Angeles School of Medicine, Los Angeles, CA; Centre Hospitalier Saint Louis, Paris, France; Hospital de Clinicas de Curitiba, Parana, Brazil; Hospital Israelita Albert Einstein, Sao Paulo, Brazil; Katedra I Klinika Hematologii I, Katowice, Poland; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Braine-l’Alleud, Belgium; UT M. D. Anderson Cancer Center, Houston, TX
| | - D. Dejardin
- University of California at Los Angeles School of Medicine, Los Angeles, CA; Centre Hospitalier Saint Louis, Paris, France; Hospital de Clinicas de Curitiba, Parana, Brazil; Hospital Israelita Albert Einstein, Sao Paulo, Brazil; Katedra I Klinika Hematologii I, Katowice, Poland; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Braine-l’Alleud, Belgium; UT M. D. Anderson Cancer Center, Houston, TX
| | - H. Kantarjian
- University of California at Los Angeles School of Medicine, Los Angeles, CA; Centre Hospitalier Saint Louis, Paris, France; Hospital de Clinicas de Curitiba, Parana, Brazil; Hospital Israelita Albert Einstein, Sao Paulo, Brazil; Katedra I Klinika Hematologii I, Katowice, Poland; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Braine-l’Alleud, Belgium; UT M. D. Anderson Cancer Center, Houston, TX
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Passweg JR, Pérez WS, Eapen M, Camitta BM, Gluckman E, Hinterberger W, Hows JM, Marsh JCW, Pasquini R, Schrezenmeier H, Socié G, Zhang MJ, Bredeson C. Bone marrow transplants from mismatched related and unrelated donors for severe aplastic anemia. Bone Marrow Transplant 2006; 37:641-9. [PMID: 16489361 DOI: 10.1038/sj.bmt.1705299] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
For patients with acquired severe aplastic anemia without a matched sibling donor and not responding to immunosuppressive treatment, bone marrow transplantation from a suitable alternative donor is often attempted. We examined risks of graft failure, graft-versus-host disease and overall survival after 318 alternative donor transplants between 1988 and 1998. Sixty-six patients received allografts from 1-antigen and 20 from >1-antigen mismatched related donors; 181 from matched and 51 from mismatched unrelated donors. Most patients were young, had had multiple red blood cell transfusions and poor performance score at transplantation. We did not observe differences in risks of graft failure and overall mortality by donor type. The probabilities of graft failure at 100 days after 1-antigen mismatched related donor, >1-antigen mismatched related donor, matched unrelated donor and mismatched unrelated donor transplants were 21, 25, 15 and 18%, respectively. Corresponding probabilities of overall survival at 5 years were 49, 30, 39 and 36%, respectively. Although alternative donor transplantation results in long-term survival, mortality rates are high. Poor performance score and older age adversely affect outcomes after transplantation. Therefore, early referral for transplantation should be encouraged for patients who fail immunosuppressive therapy and have a suitable alternative donor.
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Affiliation(s)
- J R Passweg
- Department Innere Medizin, Kantonsspital, Basel, Switzerland.
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Funke VAM, de Medeiros CR, Setúbal DC, Ruiz J, Bitencourt MA, Bonfim CM, Neto JZ, Pasquini R. Therapy for severe refractory acute graft-versus-host disease with basiliximab, a selective interleukin-2 receptor antagonist. Bone Marrow Transplant 2006; 37:961-5. [PMID: 16565744 DOI: 10.1038/sj.bmt.1705306] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Basiliximab is a chimeric monoclonal antibody that binds to the alpha chain of IL-2R on activated cytotoxic T-cells, inhibiting lymphocyte proliferation. We report 34 patients with refractory acute GVHD (grade III-IV) who received basiliximab from December 1998 to October 2003. Adults received 40 mg weekly (2-3 doses) and children received half of this dose. Median age was 13 years. Twenty-five donors were unrelated. The stem cell source was bone marrow in 30 and cord blood in four. Complete responses were seen in 27/32 patients (84%) with skin, 12/25 (48%) with gut and 6/23 (26%) with liver GVHD. Median duration of response was 38 days (5-1103). Overall survival at 5 years was 20%. Eleven patients (32%) are alive. The main causes of death were CMV (n=4), fungus (n=6), sepsis (n=8), hemorrhage (n=2), and relapse (n=2). Graft-versus-host disease flares were observed in 14 patients (41%), half being rescued by other therapies. In conclusion, basiliximab was able to induce complete responses in patients with refractory acute GVHD. Prospective studies are necessary to evaluate the optimal treatment schedule.
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Affiliation(s)
- V A M Funke
- BMT Center, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Brazil.
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Poloni A, Leoni P, Buscemi L, Balducci F, Pasquini R, Masia MC, Viola N, Costantino E, Discepoli G, Corradini P, Tagliabracci A, Olivieri A. Engraftment capacity of mesenchymal cells following hematopoietic stem cell transplantation in patients receiving reduced-intensity conditioning regimen. Leukemia 2006; 20:329-35. [PMID: 16341047 DOI: 10.1038/sj.leu.2404018] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The engraftment ability of mesenchymal cells was investigated in 26 patients receiving allogeneic transplantation from HLA-identical siblings with reduced-intensity conditioning (RIC). The stem cell source was bone marrow (BM) in eight patients and G-CSF-mobilized peripheral blood hematopoietic cells in 18 cases. A total of 32 patients engrafted very quickly and the chimerism evaluation (both on myeloid and on lymphoid subsets) showed that they were full donor by day 60. At the time of the study they were in complete hematological remission and displayed a full donor hematopoiesis. Two patients showed early disease progression while one did not engraft. Forty-eight out-marrow samples harvested from the 26 patients generated a marrow stromal layer adequate for the chimerism evaluation. Monocyte-macrophage contamination of marrow stromal layers was always reduced below 2% by repeated trypsinizations and treatment with the leucyl-leucine (leu-leu) methyl ester. The chimerism evaluation was performed by PCR analysis of STRs microsatellites and the amelogenin locus, by using capillary electrophoresis (CE) and by FISH analysis in case of the sex mismatch. In eight patients, a partial donor origin of stromal cells was shown (7-86% cells of donor). The source of hematopoietic cells was BM in three patients and mobilized peripheral blood in the other five.
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Affiliation(s)
- A Poloni
- Department of Hematology, University of Ancona, Ancona, Italy.
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Funke V, Setubal D, Ruiz J, Lima D, Bonfim C, Bitencourt M, Zanis-Neto J, de Medeiros C, Pasquini R. Low incidence of acute graft versus host disease and reduced early mortality in CP-CML patients transplanted using CSA, MTX and MP as immunoprophylaxis. Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.100] [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: 11/24/2022]
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Funke V, Samir N, Michel O, Henrique B, Nelma C, Fernanda L, Nelson H, Marci P, de Lima D, Setubal D, Jefferson R, Bonfim C, Bitencourt M, de Medeiros C, Zanis J, Pasquini R. Gleevec as therapy for relapsed Chronic Myeloid Leukemia (CML) and Ph+ Acute Lymphoblastic Leukemia (ALL) after Bone Marrow Transplantation (BMT). Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.074] [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]
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43
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Bonfim C, Barriga F, Wietstruck M, Setubal D, Ruiz J, Funke V, Koliski A, Bitencourt M, Pasquini R. Stem cell transplantation (SCT) for patients with Wiskott Aldrich Syndrome (WAS): Analysis of 19 pts transplanted in Brazil and Chile. Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.391] [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]
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Bonfim C, Bitencourt M, Funke V, Setubal D, Ruiz J, Doro M, Medeiros C, Zanis-Neto J, Pasquini R. Bone Marrow Transplantation (BMT) for heavily Transfused Patients (pts) with Severe Aplastic Anemia (SAA): 147 pts treated at the same institution with Busulfan (BU) + Cyclophosphamide (CY). Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.086] [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]
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Bonfim C, Bitencourt M, Funke V, Setubal D, Ruiz J, Seber A, Pilonetto D, Medeiros C, Zanis-Neto J, Pasquini R. Stem cell transplantation in 40 pts with Fanconi anemia (FA): Excellent survival and low toxicity for pts with a related HLA identical donor. Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.380] [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: 11/24/2022]
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Bonfim C, Setubal D, Bitencourt M, Funke V, Ruiz J, Koliski A, Medeiros C, Zanis-Neto J, Pasquini R. High incidence of graft failure and transplant related mortality (TRM) in 50 children receiving unrelated umbilical cord blood transplantation (UCBT) for non-malignant diseases. Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.379] [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: 10/25/2022]
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Zanis-Neto J, Flowers MED, Medeiros CR, Bitencourt MA, Bonfim CM, Setúbal DC, Funke V, Sanders J, Deeg HJ, Kiem HP, Martin P, Leisenring W, Storb R, Pasquini R. Low-dose cyclophosphamide conditioning for haematopoietic cell transplantation from HLA-matched related donors in patients with Fanconi anaemia. Br J Haematol 2005; 130:99-106. [PMID: 15982351 DOI: 10.1111/j.1365-2141.2005.05549.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Allogeneic haematopoietic cell transplantation (HCT) is effective therapy for Fanconi anaemia (FA). FA patients do not tolerate conditioning with 200 mg/kg of cyclophosphamide (Cy), typically used in aplastic anaemia. We previously published results of studies in which Cy doses were gradually reduced from 200 to 100 mg/kg. Here we update results of the initial studies and report data on 30 new patients conditioned with Cy either at 80 mg/kg (n = 7) or at 60 mg/kg (n = 23), given over 4 days before HCT from human leucocyte antigen-matched related donors. Methotrexate and cyclosporine were given for graft-versus-host disease (GVHD) prophylaxis. All seven patients given Cy at 80 mg/kg and 21 of 23 given Cy at 60 mg/kg had sustained engraftment, while two patients, both with clonal cytogenetics abnormalities, experienced graft failure. Grades 2-3 acute GVHD rates were 57% and 14% for patients given the higher and lower Cy doses, respectively (P = 0.001). Four patients given Cy at 80 mg/kg and 22 given Cy at 60 mg/kg were alive at a median of 47 (44-58) months and 16 (3-52) months, respectively. Cy at 60 mg/kg has acceptable toxicities, low rates of GVHD, and is sufficient for engraftment of related grafts in most FA patients.
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Affiliation(s)
- J Zanis-Neto
- The Bone Marrow Transplantation Center at the University of Parana, Curitiba, PA, Brazil
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Caldini G, Trotta F, Villarini M, Moretti M, Pasquini R, Scassellati-Sforzolini G, Cenci G. Screening of potential lactobacilli antigenotoxicity by microbial and mammalian cell-based tests. Int J Food Microbiol 2005; 102:37-47. [PMID: 15925000 DOI: 10.1016/j.ijfoodmicro.2004.11.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2003] [Revised: 07/02/2004] [Accepted: 11/08/2004] [Indexed: 11/19/2022]
Abstract
Antigenotoxicity is considered an important property for probiotic lactobacilli. The ability of non probiotic lactobacilli from dairy products and starters to inhibit two reference genotoxins: 4-nitroquinoline-1-oxide and N-methyl-N'-nitro-N-nitrosoguanidine was evaluated. The study was carried out using short-term assays with different targets, such as procaryotic cells (SOS-Chromotest for genotoxicity in Escherichia coli and Ames test for mutagenicity in Salmonella typhimurium) and eucaryotic cells (Comet assay for genotoxicity in Caco-2 enterocytes). A high proportion of strains inhibiting 4-nitroquinoline-1-oxide activity was found in Lactobacillus casei, Lactobacillus acidophilus, Lactobacillus rhamnosus, Lactobacillus delbrueckii subsp. bulgaricus and Lactobacillus plantarum. Inhibition of N-methyl-N'-nitro-N-nitrosoguanidine activity occurred in only one L. acidophilus strain. All the strains with antigenotoxic properties also demonstrated antimutagenic activity and produced modifications in genotoxin spectroscopic profiles. Strain viability during and after genotoxin exposure was confirmed. Concordance of the results obtained with microbial and mammalian cell-based tests is underlined.
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Affiliation(s)
- G Caldini
- Dipartimento Biologia Cellulare e Molecolare, Università di Perugia, Via del Giochetto, I-06126 Perugia, Italy
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Barton D, Hamerschlak N, Pasquini R, Dulley FL, Colturato VAR, Brandalise SR, de Souza CA, Voltarelli J, Ruiz MA, Rotolo M, Ginani VC. Stem cell transplantation for acute myeloid leukemia (AML): The Brazilian experience. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- D. Barton
- HIAE, Sao Paulo, Brazil; UFPR, Curitiba, Brazil; HC-FMUSP, Sao Paulo, Brazil; H. Amaral Carvalho, Jau, Brazil; H. Inf. Dr. Boldrini, Campinas, Brazil; UNICAMP, Campinas, Brazil; HC-FMRP, Ribeirao Preto, Brazil; FM-SJRP, SP, Brazil; CEPON, Florianopolis, Brazil; IOP/GRAAC, Sao Paulo, Brazil
| | - N. Hamerschlak
- HIAE, Sao Paulo, Brazil; UFPR, Curitiba, Brazil; HC-FMUSP, Sao Paulo, Brazil; H. Amaral Carvalho, Jau, Brazil; H. Inf. Dr. Boldrini, Campinas, Brazil; UNICAMP, Campinas, Brazil; HC-FMRP, Ribeirao Preto, Brazil; FM-SJRP, SP, Brazil; CEPON, Florianopolis, Brazil; IOP/GRAAC, Sao Paulo, Brazil
| | - R. Pasquini
- HIAE, Sao Paulo, Brazil; UFPR, Curitiba, Brazil; HC-FMUSP, Sao Paulo, Brazil; H. Amaral Carvalho, Jau, Brazil; H. Inf. Dr. Boldrini, Campinas, Brazil; UNICAMP, Campinas, Brazil; HC-FMRP, Ribeirao Preto, Brazil; FM-SJRP, SP, Brazil; CEPON, Florianopolis, Brazil; IOP/GRAAC, Sao Paulo, Brazil
| | - F. L. Dulley
- HIAE, Sao Paulo, Brazil; UFPR, Curitiba, Brazil; HC-FMUSP, Sao Paulo, Brazil; H. Amaral Carvalho, Jau, Brazil; H. Inf. Dr. Boldrini, Campinas, Brazil; UNICAMP, Campinas, Brazil; HC-FMRP, Ribeirao Preto, Brazil; FM-SJRP, SP, Brazil; CEPON, Florianopolis, Brazil; IOP/GRAAC, Sao Paulo, Brazil
| | - V. A. R. Colturato
- HIAE, Sao Paulo, Brazil; UFPR, Curitiba, Brazil; HC-FMUSP, Sao Paulo, Brazil; H. Amaral Carvalho, Jau, Brazil; H. Inf. Dr. Boldrini, Campinas, Brazil; UNICAMP, Campinas, Brazil; HC-FMRP, Ribeirao Preto, Brazil; FM-SJRP, SP, Brazil; CEPON, Florianopolis, Brazil; IOP/GRAAC, Sao Paulo, Brazil
| | - S. R. Brandalise
- HIAE, Sao Paulo, Brazil; UFPR, Curitiba, Brazil; HC-FMUSP, Sao Paulo, Brazil; H. Amaral Carvalho, Jau, Brazil; H. Inf. Dr. Boldrini, Campinas, Brazil; UNICAMP, Campinas, Brazil; HC-FMRP, Ribeirao Preto, Brazil; FM-SJRP, SP, Brazil; CEPON, Florianopolis, Brazil; IOP/GRAAC, Sao Paulo, Brazil
| | - C. A. de Souza
- HIAE, Sao Paulo, Brazil; UFPR, Curitiba, Brazil; HC-FMUSP, Sao Paulo, Brazil; H. Amaral Carvalho, Jau, Brazil; H. Inf. Dr. Boldrini, Campinas, Brazil; UNICAMP, Campinas, Brazil; HC-FMRP, Ribeirao Preto, Brazil; FM-SJRP, SP, Brazil; CEPON, Florianopolis, Brazil; IOP/GRAAC, Sao Paulo, Brazil
| | - J. Voltarelli
- HIAE, Sao Paulo, Brazil; UFPR, Curitiba, Brazil; HC-FMUSP, Sao Paulo, Brazil; H. Amaral Carvalho, Jau, Brazil; H. Inf. Dr. Boldrini, Campinas, Brazil; UNICAMP, Campinas, Brazil; HC-FMRP, Ribeirao Preto, Brazil; FM-SJRP, SP, Brazil; CEPON, Florianopolis, Brazil; IOP/GRAAC, Sao Paulo, Brazil
| | - M. A. Ruiz
- HIAE, Sao Paulo, Brazil; UFPR, Curitiba, Brazil; HC-FMUSP, Sao Paulo, Brazil; H. Amaral Carvalho, Jau, Brazil; H. Inf. Dr. Boldrini, Campinas, Brazil; UNICAMP, Campinas, Brazil; HC-FMRP, Ribeirao Preto, Brazil; FM-SJRP, SP, Brazil; CEPON, Florianopolis, Brazil; IOP/GRAAC, Sao Paulo, Brazil
| | - M. Rotolo
- HIAE, Sao Paulo, Brazil; UFPR, Curitiba, Brazil; HC-FMUSP, Sao Paulo, Brazil; H. Amaral Carvalho, Jau, Brazil; H. Inf. Dr. Boldrini, Campinas, Brazil; UNICAMP, Campinas, Brazil; HC-FMRP, Ribeirao Preto, Brazil; FM-SJRP, SP, Brazil; CEPON, Florianopolis, Brazil; IOP/GRAAC, Sao Paulo, Brazil
| | - V. C. Ginani
- HIAE, Sao Paulo, Brazil; UFPR, Curitiba, Brazil; HC-FMUSP, Sao Paulo, Brazil; H. Amaral Carvalho, Jau, Brazil; H. Inf. Dr. Boldrini, Campinas, Brazil; UNICAMP, Campinas, Brazil; HC-FMRP, Ribeirao Preto, Brazil; FM-SJRP, SP, Brazil; CEPON, Florianopolis, Brazil; IOP/GRAAC, Sao Paulo, Brazil
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Moura GL, Pasquini R, Padilha S, Viana K, Minucelli S, Silva AG, Albini L. High-risk gestational trophoblastic disease: Fifteen years of experience. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.5126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | - K. Viana
- Hosp De Clinicas, Parana, Brazil
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