ABSTRACT
Nodal peripheral T-cell lymphomas are a rare group of neoplasms derived from post-thymic and activated T lymphocytes. A review of scientific articles listed in PubMed, Lilacs, and the Cochrane Library databases was performed using the term "peripheral T-cell lymphomas". According to the World Health Organization classification of hematopoietic tissue tumors, this group of neoplasms consists of peripheral T-cell lymphoma not otherwise specified (PTCL-NOS), angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma-anaplastic lymphoma kinase positive (ALCL-ALK+), and a provisional entity called anaplastic large cell lymphoma-anaplastic lymphoma kinase negative (ALCL-ALK-). Because the treatment and prognoses of these neoplasms involve different principles, it is essential to distinguish each one by its clinical, immunophenotypic, genetic, and molecular features. Except for anaplastic large cell lymphoma-anaplastic lymphoma kinase positive, which has no adverse international prognostic index, the prognosis of nodal peripheral T-cell lymphomas is worse than that of aggressive B-cell lymphomas. Chemotherapy based on anthracyclines provides poor outcomes because these neoplasms frequently have multidrug-resistant phenotypes. Based on this, the current tendency is to use intensified cyclophosphamide, doxorubicin, vincristine, prednisolone (CHOP) regimens with the addition of new drugs, and autologous hematopoietic stem cell transplantation. This paper describes the clinical features and diagnostic methods, and proposes a therapeutic algorithm for nodal peripheral T-cell lymphoma patients...
Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Immunophenotyping , Lymphoma, T-Cell/diagnosis , Lymphoma, T-Cell/therapy , World Health OrganizationABSTRACT
O objetivo do estudo foi caracterizar a leishmaniose tegumentar em pacientes do Distrito Federal, investigar infecção subclínica nos moradores das localidades dos pacientes e identificar as espécies de flebotomíneos e leishmanias. Foram selecionados pacientes atendidos no Hospital Universitário de Brasília de agosto de 2006 a junho de 2007. Parentes e vizinhos dos mesmos foram submetidos à intradermorreação de Montenegro e imunofluorescência indireta. Foram capturados flebotomíneos nas localidades de origem dos pacientes e identificados quanto às espécies, bem como foram identificadas as espécies de leishmanias encontradas nos pacientes. Foram registrados 10 casos autóctones de leishmaniose tegumentar. Em 32 moradores, foi realizada intradermorreação, com positividade de 71,8 por cento. Trinta e sete imunofluorescências realizadas foram negativas. Foram capturadas Lutzomyia whitmani, inclusive no domicílio/peridomicílio e Lutzomyia flaviscutellata. O percentual de positividade das intradermorreações de Montenegro sugere infecção subclínica dos moradores. A captura do vetor Lutzomyia whitmani no peri/intradomicílio sugere transmissão peri/intradomicíliar.
The objectives of this study were to characterize cutaneous leishmaniasis in patients from the Federal District, investigate subclinical infection in people living in the same localities as patients and identify the species of Phlebotomus and Leishmania. Patients attended at the University Hospital of Brasília between August 2006 and June 2007 were selected. Relatives and neighbors of the patients underwent the Montenegro intradermal test and indirect immunofluorescence. Phlebotomines were caught at the localities where the patients came from and their species were identified. The species of Leishmania in the patients were also identified. Ten autochthonous cases of cutaneous leishmaniasis were recorded. The intradermal test was done on 32 local residents and 71.8 percent were positive. Immunofluorescence was performed on 37 individuals and all of them were negative. Lutzomyia whitmani was caught, including in domestic/peridomestic areas, along with Lutzomyia flaviscutellata. The percentage of positive Montenegro intradermal tests suggests that the local residents had subclinical infection. Capture of the vector Lutzomyia whitmani in domestic/peridomestic areas suggests that domestic/peridomestic transmission was occurring.