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Braz. j. biol ; 83: e249911, 2023. tab, graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1339366


Abstract Hematological and hematopoietic cells malignancies of the genes and hematopoietic cells are associated with the genetic mutation, often at the chromosomal level. The standard cytogenetic study is widely accepted as one of the main diagnostics and prognostic determinants in patients. Therefore, the current descriptive and cross-sectional study sought to determine the cytogenetic analysis of frequent hematological malignancies in Pakistan. A total of 202 peripheral bone marrow or blood samples from patients with benign and malignant hematological malignancy were taken using a conventional G-banding technique. Among enrolled patients, the mean age was 21.5 years ± 23.4, and gender-wise distribution showed a marked predominance of the male 147 (73%) population compared to the female 55 (27%). Patients in the age group (2-10 years) had the highest frequency, 48 (24%), of hematological neoplasms, followed by age (11-20 years) with 40 (20%). Normal karyotypes (46, XX/46, XY) was found in 51% (n=103) patients. Furthermore, the frequency of complex karyotype was 30 (15%), while normal was seen in 171 (85%) patients. Pre-B Acute Lymphoblastic Leukemia (Pre-B ALL) was the most prevalent malignancy of 66 (33%), followed by Chronic Myelogenous Leukemia (CML) of 41 (20%) and Acute Lymphocytic Leukemia of 29 (14%). Translocation was the most prevalent 50 (25%), followed by hypotriploidy 14 (7%) and monosomy 8 (4%) on chromosome aberration analysis. In addition, t(9:22) translocation was found to be 20 (10%) in CML, with the majority in the age group (31-40 years). This study recommends that karyotyping should be tested frequently in hematological conditions because it may provide insight into the relative chromosomal changes associated with particular malignancies.

Resumo As neoplasias hematológicas e de células hematopoiéticas dos genes e as células hematopoiéticas estão associadas à mutação genética, geralmente em nível cromossômico. O estudo citogenético padrão é amplamente aceito como um dos principais determinantes diagnósticos e prognósticos em pacientes. Portanto, o presente estudo descritivo e transversal buscou determinar a análise citogenética de neoplasias hematológicas frequentes no Paquistão. Um total de 202 amostras de medula óssea periférica ou sangue de pacientes com malignidade hematológica benigna e maligna foi coletado usando uma técnica convencional de banda G. Entre os pacientes inscritos, a média de idade foi de 21,5 anos ± 23,4, e a distribuição por gênero mostrou uma marcada predominância da população masculina de 147 (73%) em comparação com a feminina de 55 (27%). Pacientes na faixa etária (2-10 anos) tiveram a maior frequência, 48 (24%), de neoplasias hematológicas, seguida da idade (11-20 anos) com 40 (20%). Cariótipos normais (46, XX / 46, XY) foram encontrados em 51% (n = 103) dos pacientes. Além disso, a frequência de cariótipo complexo foi de 30 (15%), enquanto normal foi observada em 171 (85%) pacientes. Leucemia linfoblástica aguda pré-B (LLA Pré-B) foi a doença maligna mais prevalente de 66 (33%), seguida por leucemia mieloide crônica (LMC) de 41 (20%) e leucemia linfocítica aguda de 29 (14%). A translocação foi o 50 mais prevalente (25%), seguido por hipotriploidia 14 (7%) e monossomia 8 (4%) na análise de aberração cromossômica. Além disso, a translocação t (9:22) encontrada foi de 20 (10%) na LMC, com a maioria na faixa etária (31-40 anos). Este estudo recomenda que o cariótipo deve ser testado com frequência em condições hematológicas porque pode fornecer informações sobre as alterações cromossômicas relativas associadas a doenças malignas específicas.

Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Young Adult , Chromosome Aberrations , Hematologic Neoplasms/genetics , Hematologic Neoplasms/epidemiology , Pakistan/epidemiology , Cross-Sectional Studies , Karyotyping
Hematol., Transfus. Cell Ther. (Impr.) ; 44(1): 26-31, Jan.-Mar. 2022. tab
Article in English | LILACS | ID: biblio-1364890


Abstract Introduction Coronavirus disease 2019 (COVID-19) may present with extrapulmonary manifestations, including hematologic changes. Previous studies suggest that severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) can interact with the renin-angiotensin system, ultimately causing increased production of angiotensin II. By reporting the cases of previously healthy young adults diagnosed with a hematologic malignancy after experiencing COVID-19, we raise the hypothesis that the SARS-Cov-2 infection could act as a trigger for leukemogenesis in predisposed individuals. Methods This was a case series performed through extraction of relevant clinical information from the medical records of three patients admitted to our Hematology unit between August 2020 and September 2020. Main Results Considering the relatively rapid development of cytopenias following recovery from COVID-19, it cannot be ruled out that SARS-Cov-2 played a role in leukemogenesis in those patients. Based on previous in vitro studies, the renin-angiotensin system imbalance induced by SARS-CoV-2 could potentially promote in vivo leukemogenesis through several mechanisms. Conclusion Despite the advances in pathophysiological and clinical characterization of COVID-19, the consequences of the pandemic to the incidence of hematologic diseases are still to be elucidated. In this context, future dissection of the status of the local bone marrow renin-angiotensin system in leukemogenesis is a clinically relevant basic research area.

Humans , Male , Female , Adult , Hematologic Neoplasms , COVID-19 , Renin-Angiotensin System , Leukemia , SARS-CoV-2
Hematol., Transfus. Cell Ther. (Impr.) ; 43(2): 185-190, Apr.-June 2021. tab, ilus
Article in English | LILACS | ID: biblio-1286676


ABSTRACT Introduction Multiple myeloma is a progressive and incurable hematological disease characterized by disordered and clonal multiplication of plasmacytes in the bone marrow. The main clinical manifestations are caused by the presence of neoplastic cells in bone tissue, as well as the excessive production of immunoglobulins and normal humoral immunity suppression. Daratumumab is an anti-CD38 monoclonal antibody that has promising results in managing the multiple myeloma disease. Objective This study aimed to investigate the scientific evidence concerning the impact of the cytomegalovirus infections in the daratumumab treatment course in extensively pretreated multiple myeloma patients. Method To this end, an integrative literature review was performed in different databases, comprising a 5-year period. Results The studies analysis revealed that the cytomegalovirus infection reactivation can occur during the use of daratumumab in multiple myeloma patients previously treated, which led to treatment discontinuation, compromised the drug efficacy and favored the disease progression. Moreover, it was observed that even with prophylactic antiviral therapy there was an infection reactivation in some cases, as well as deaths, in more severe situations. Conclusion Thus, even considering that few reports on such a topic are available in the scientific literature, the present review showed that cytomegalovirus reactivation can impair daratumumab therapy, mainly in multiple myeloma patients heavily pretreated. In addition, this study could contribute as a tool for the clinical decision and management of adverse effects in medical practices, demonstrating the importance of patient monitoring for the possibility of cytomegalovirus reactivation in heavily pretreated myeloma patients.

Humans , Cytomegalovirus Infections , Antibodies, Monoclonal , Multiple Myeloma/therapy , Virus Diseases , Review , Hematologic Neoplasms , Immune System , Immunotherapy
Medicina (B.Aires) ; 81(3): 396-400, jun. 2021. graf
Article in Spanish | LILACS | ID: biblio-1346475


Resumen La infección por SARS-CoV-2 en pacientes con neoplasias hematológicas y trasplantes de células progenitoras hematopoyéticas (TCPH) puede ser grave y con importante mortalidad. Llevamos a cabo un estudio prospectivo y observacional que tuvo como objetivo describir las características clínicas, epide miológicas y la evolución de la infección por SARS-CoV-2 en pacientes con neoplasias hematológicas y TCPH. Se incluyeron 20 pacientes adultos con una mediana de edad de 58 años y una mediana de score de Charlson de 3. Las infecciones fueron de adquisición comunitaria y nosocomial en el 60% y 40% respectivamente, y el 30% de los pacientes tenía antecedente de contacto con una persona infectada por SARS-CoV-2. El 65% pre sentó infiltrados pulmonares, mayormente con patrón de vidrio esmerilado en la tomografía computarizada de tórax. Casi la mitad de los pacientes tuvo enfermedad grave y crítica, y una alta proporción recibió plasma de convalecientes como tratamiento. Presentaron complicaciones e infecciones hospitalarias el 20% y 15% respec tivamente, y tuvieron una mediana de días de internación prolongada. La mortalidad a 30 días fue del 10%. La infección por SARS-CoV-2 en nuestra población tuvo considerable impacto clínico y epidemiológico.

Abstract. SARS-CoV-2 infection in patients with hematological malignancies and hematopoietic stem cell transplants (HSCT) can be severe and with significant mortality. We carried out a prospective and observational study to describe the clinical and epidemiological characteristics and outcome of SARS-CoV-2 infection in patients with hematological malignancies and HSCT. Twenty adult patients were included with a median age of 58 years and a median Charlson score of 3. Infections were community-acquired and nosocomial in 60% and 40%, respectively, and 30% of the patients had a history of contact with a SARS-CoV-2 infected person. Sixty-five percent had pulmonary infiltrates, mostly with a ground-glass pattern on CT scan. Almost half of the patients had a severe and critical illness, and a high proportion received convalescent plasma as treatment. Twenty percent and 15% had complications and hospital infections, respectively, and had prolonged hospitalization expressed as median days of it. The 30-day mortality was 10%. SARS-CoV-2 infection in our population had a considerable clinical and epidemiological impact.

Humans , Adult , Middle Aged , Hematologic Neoplasms/complications , Hematologic Neoplasms/therapy , COVID-19/therapy , Prospective Studies , Immunization, Passive , SARS-CoV-2
Oncol. (Guayaquil) ; 31(1): 46-55, Abril 30, 2021.
Article in Spanish | LILACS | ID: biblio-1222458


Introducción: Dentro de las cinco primeras neoplasias en el mundo están las Leucemias, la misma que ha venido incrementándose en las últimas décadas. El objetivo del presente estudio fue determi-nar las características epidemiológicas de las Neoplasias del tejido Hematopoyético y linfoide en pacientes atendidos en el Instituto Oncológico Nacional-SOLCA Guayaquil durante los años 2015 al 2019. Metodología: Se efectuó un estudio de diseño observacional, descriptivo poblacional; donde el universo y la muestra fueron 891 casos nuevos de neoplasias del Tejido Hematopoyético y Linfoide, recolectándose los datos en una matriz, que fueron tomados del programa informático del registro de tumores. Resultados: se diagnosticaron Leucemias Linfoideas (69.58%) y Leucemias Mieloides (30.30%); más en hombres (53.33%) que mujeres (44.67%); siendo los casos en menores de 19 años en Gua-yaquil del 57.33% y en Otras ciudades con el 64.36%; en Guayaquil el grupo de edad de 5 ­ 9 años fue más frecuente con 20.57% seguido de los menores de 5 años con 19.02%; mientras que en Otras ciudades fueran los menores de 5 años con 20.72% seguido del grupo etario de 5 ­ 9 años con 18.33%; entre otros grupos. Su mayor frecuencia en Guayaquil fueron en parroquias Tarqui, Ximena y en Otras ciudades en Región Costa (81.47%). Conclusión: Dentro de las neoplasias del Tejido Hematopoyético y Linfoide la más común fue las Leucemias Linfoideas en la población menor de 19 años con énfasis en los niños menores de 5 años mostrando una presencia importante en los años de estudio en Guayaquil y en la región Costa del Ecuador.

Introduction: Leukemias are among the first five neoplasms in the world, the same one that has been increasing in recent decades. The aim of this study was to determine the epidemiological char-acteristics of Hematopoietic and Lymphoid Neoplasms in patients treated at the National Oncological Institute-SOLCA Guayaquil during the years 2015 to 2019. Methodology: An observational, descriptive population study was carried out; Where the universe and the sample were 891 new cases of Hematopoietic and Lymphoid neoplasms, the data was col-lected in a matrix, taken from the tumor registry computer program. Results: Lymphoid Leukemias were diagnosed in 69.58% and Myeloid Leukemias with 30.30%; more in men (53.33%) than women (44.67%); being the cases in minors of 19 years in Guayaquil 57.33% and in Other cities it had 64.36%; in Guayaquil the age group of 5 - 9 years was more frequent with 20.57% followed by those under 5 years with 19.02%; while in Other cities under 5 years old with 20.72% followed by the age group of 5 - 9 years old with 18.33%; among other groups. Its highest frequency in Guayaquil was in Tarqui and Ximena parishes and in other cities it was in the Coastal Region with 81.47%. Conclusion: Among the Hematopoietic and Lymphoid neoplasms the most common was Lym-phoid Leukemias in the population under 19 years of age, with emphasis on children under 5 years of age, showing an important presence in the years of study in Guayaquil and in the Ecuadorian Coastal region.

Leukemia , Hematologic Neoplasms , Health Services Research , Epidemiology , Hematopoietic System
Oncol. (Guayaquil) ; 31(1): 56-65, Abril 30, 2021.
Article in Spanish | LILACS | ID: biblio-1222459


Introducción: La fatiga es un problema relevante en pacientes con cáncer hematológico y puede ser un motivo de reducción importante de la calidad de vida. El objetivo del presente estudio fue realizar un estudio descriptivo de un grupo de niños y adolescentes portadores de neoplasias de origen hematológico en un centro único de referencia. Metodología: El presente estudio observacional tiene un corte retrospectivo, en donde se incluyeron pacientes menores a 18 años con el diagnóstico de cáncer hematológico en quienes se revisó la historia clínica y se realizó un test de calidad de vida. Se realiza un análisis de correlación entre las variables usando estadística no paramétrica. Resultados: ingresaron al estudio 64 pacientes. De sexo masculino (n=37) y femenino (n=27). El valor medio de fatiga fue (5.72 ± 0.53 y 5.85 ± 0.51), en actividad física y salud (1.49 ± 0.17 y 1.44 ± 0.13) en hombres y mujeres respectivamente. El valor medio de edad fue de 5.81 ± 2.46 en el rango de 2 a 10 años y 14.55 ±2.15 en el rango de 11 a 18 años. Según el rango etario existió más predominancia de fatiga en niños que en adolescentes y más en mujeres que en hombres. Conclusión: No se encontró relación entre las variables de estudio. Sin embargo, los hallazgos expuestos indican una marcada sensación de fatiga siendo esta moderada pudiendo convertirse en severa; de igual manera se obtuvo niveles bajos y medios de calidad de vida en las similares dimensiones incluidas en las baterías de evaluación; sugiriendo futuras investigaciones incluyendo colaboración de abordaje multidisciplinaria para llegar a impartir las terapias adecuadas que beneficien a los pacientes con cáncer.

Introduction: Fatigue is a relevant problem in patients with hematological cancer and can be a reason for a significant reduction in quality of life. The objective of this study was a descriptive study of a group of children and adolescents with neoplasms of hematological origin in a single referral center. Methodology: The present observational study has a retrospective cut-off, which included patients under 18 years of age with a diagnosis of hematological cancer in whom the clinical history was reviewed and a quality of life test was performed. A correlation analysis between the variables is performed using non-parametric statistics. Results: 64 patients entered the study. Male (n = 37) and female (n = 27). The mean value of fatigue was (5.72 ± 0.53 and 5.85 ± 0.51), in physical activity and health (1.49 ± 0.17 and 1.44 ± 0.13) in men and women respectively. The mean age value was 5.81 ± 2.46 in the range of 2 to 10 years and 14.55 ± 2.15 in the range of 11 to 18 years. According to the age range, there was more prevalence of fatigue in children than in adolescents and more in women than in men. Conclusion: No relationship was found between the study variables. However, the results shown indicate a marked feeling of fatigue, this being moderate and it can become severe; in the same way, low and medium levels of quality of life were obtained in the similar dimensions included in the eval-uation batteries; suggesting future research including collaboration of a multidisciplinary approach to arrive at the delivery of appropriate therapies that benefit cancer patients.

Quality of Life , Hematologic Neoplasms , Fatigue , Epidemiology , Health Services Research
Infectio ; 25(1): 71-74, ene.-mar. 2021. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1154407


Resumen La bacteremia por Streptococcus gordonii es infrecuente. Su aislamiento en hemocultivo traduce alta significancia clínica y debe dirigir el abordaje diagnóstico hacia la búsqueda de entidades subyacentes como neoplasias hematológicas, cardiopatías valvulares, neumonía, alteraciones estructurales de cabeza y cuello, inmunosupresión, y otras condiciones asociadas. No se han identificado reportes en pacientes con neoplasia de vías urinarias como posible condicionante de bacteremia por este agente. Se describe el caso de un paciente que, durante el estudio de bacteremia por este microorganismo, fue diagnosticado de carcinoma urotelial de alto grado.

Abstract Streptococcus gordonii bacteremia is rare. Its isolation in blood culture translates into high clinical significance and the diagnostic approach should be directed towards the search for underlying entities such as hematologic malignancies, valvular heart disease, pneumonia, structural changes of the head and neck, immunosuppression and other related conditions. No reports have been identified in patients with urinary tract neoplasia as a possible condition of bacteremia by this agent. The case of a patient who was diagnosed with high-grade urothelial carcinoma during the study of bacteremia by this microorganism is described.

Humans , Male , Aged, 80 and over , Carcinoma , Bacteremia , Streptococcus gordonii , Urinary Tract , Immunosuppression , Sepsis , Hematologic Neoplasms , Neoplasms
Rev. bras. anal. clin ; 53(1): 90-96, 20210330. tab, ilus
Article in Portuguese | LILACS | ID: biblio-1291778


Descrição: Relato de caso de um paciente com um transcrito raro (e1a2) na Leucemia Mieloide Crônica (LMC) e outro com uma translocação rara na Síndrome Mielodisplásica (SMD). Discussão: O transcrito e1a2 possui frequência de 1% entre os casos de LMC, já a translocação t(11,17)(q23;q21) não foi evidenciada em paciente com SMD do tipo Anemia Refratária com Excesso de Blastos (AREB) do tipo 2. Conclusão: Ambos os casos apresentados possuem associação incomum entre fenótipo e genótipo. A correlação da clínica com os achados laboratoriais é importante para a determinação fidedigna do diagnóstico e prognóstico destes pacientes.

Description: Case report of a patient with a rare transcript (e1a2) in Chronic Myeloid Leukemia (CML) and another with a rare translocation in Myelodysplastic Syndrome (SMD). Discussion: The transcript e1a2 has a frequency of 1% in CML cases, whereas t (11,17) (q23; q21) translocation was not observed in a patient with type of Refractory Anemia with Excess Blasts (AREB) type 2. Conclusion: Both cases reported have unusual association between phenotype and genotype. The correlation of the clinic with the laboratory findings is important for the reliable determination of the diagnosis and prognosis of these patients.

Humans , Female , Middle Aged , Phenotype , Translocation, Genetic , Anemia, Refractory , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Leukemia , Hematologic Neoplasms , Genotype
Rev. ANACEM (Impresa) ; 15(1): 18-25, 2021. graf, tab
Article in Spanish | LILACS | ID: biblio-1248003


INTRODUCTION: Before the start of the GES program in 2002, mortality was 128.2 deaths per million children under 15 years of age (RENCI). This public program managed to ensure the opportunity for diagnosis and treatment in children under 15 years of age and those less than 25 years of age who recur. Objective: To assess how GES has impacted on in-hospital mortality and lethality between1997and 2016. Methods: Retrospective case control study of 28,997 hospital discharges and 12,434 deaths analyzed using Prais-Weinstein time series between the years 1997 to 2016. They prepared contingency tables with data on: hospital discharges, age, sex and forecasts for 2001 and 2016. Fisher's p <0.05 test was used. Results: For the PreGes period an increase of 1.8% in the male crude mortality rate was observed, while for the Post Ges period an increase was observed with a breaking point at the end of 2008, with an increase of 11.04% compared to the PreGes period. An unexpected increase in the female mortality rate was observed. The odd's ratios associated with sex (higher mortality inmen than in women)0.816CI-0.679- 0.982; p <0.05; OR'S age 1,047 (0.981 per year) IC-1.044-1.051; p <0.0001 FORECAST (FONASA-1.942 IC 1.304-2.89 / ISAPRE = 2.186; IC = 1.267-3.773 p <0.005); Hospitalization days = 1.031 confirmed our research hypothesis 1.026-1.035 p <0.0001. Conclusion: This study found that there are statistically significant differences regarding hospital discharges between the public-private system, in relation to mortality andincreasein sustained crudemalemortality between the years1997 to 2016

INTRODUCCIÓN: Antes del inicio del programa GESen2002, la mortalidad era 128,2 muertes por millón de niños menores de 15 años (RENCI). Este programa público logró asegurar la oportunidad de diagnóstico y tratamiento en menores de15 años y aquellos menores de25añosque recidivan. Objetivo: Evaluar cómo el GES ha impactado en la mortalidad y letalidad intrahospitalaria entre1997a2016. Métodos: Estudio retrospectivo de control de casos en 28.997 egresos hospitalarios y 12.434 defunciones analizadas mediante series temporales de Prais-Weinstein entre los años 1997 a 2016. Se prepararon tablas de contingencia con datos sobre: egresos hospitalarios, edad, sexo y previsiones para2001y 2016.Se utilizóla prueba p <0.05de Fisher. Resultados: Se observó para el período PreGES un incremento de 1.8% en la tasa mortalidad cruda masculina, mientras que para el período Post GES se observó un incremento con punto de quiebre a fines del año 2008, con incremento del 11,04% respecto al período PreGES. Se observó incremento no sostenido en la tasa mortalidad femenina. Los odd's ratios asociados al sexo (mayor mortalidad en hombres que en mujeres) 0.816 IC-0.679-0.982; p <0,05; OR'S edad 1,047 (0.981 por año) IC-1.044-1.051; p<0.0001 PREVISIÓN (FONASA-1.942 IC 1.304-2.89 / ISAPRE =2.186; IC= 1,267-3,773 p<0.005); Días de Hospitalización=1,031 confirmó nuestra hipótesis de investigación 1,026-1,035 p<0.0001. Conclusión: Este estudio encontró que hay diferencias estadísticamente significativas respecto egresos hospitalarios entre el sistema público privado, en relación con la mortalidad e incremento en la mortalidad cruda masculina sostenida entre los años 1997 a 2016. acción en la función auditiva mediante audiometría tonal.

Humans , Male , Female , Child, Preschool , Child , Adolescent , Leukemia , Hospital Mortality , Hematologic Neoplasms/mortality , Hospitals/statistics & numerical data , Chile/epidemiology , Retrospective Studies , Risk Factors , Models, Statistical , Lymphoma
Autops. Case Rep ; 11: e2021324, 2021. graf
Article in English | LILACS | ID: biblio-1285406


Intravascular large B-cell lymphoma (IVLBCL) is a rare form of diffuse large B-cell lymphoma, characterized by malignant B-cells primarily localized to the lumina of small- and medium-sized blood vessels without lymphadenopathy. Two patients initially presented with fever of unknown origin and persistent lactic acidosis without evidence of tissue hypoxia. Neither patient had an identifiable source of infection and both underwent peripheral blood smear demonstrating leukocytosis with a neutrophilic predominance and thrombocytopenia without evidence of hematologic malignancy. One had previously had a bone marrow biopsy which was unremarkable. Both patients' condition deteriorated rapidly, progressing to multiorgan failure requiring pressors and mechanical ventilation, which ultimately resulted in cardiopulmonary arrest. At autopsy, each patient demonstrated malignant lymphocytoid cells, staining positive for CD20, localized to the lumina of small- and medium-sized vessels in multiple organs, including the lungs, liver, spleen, and kidneys, among others, allowing for the diagnosis of IVLBCL. IVLBCL is exceedingly rare, which in combination with significant variability in presentation, can make identification and diagnosis challenging. Diagnosis requires biopsy, therefore a high index of suspicion is needed to obtain an adequate tissue sample, whether pre- or postmortem. In the presented cases, both patients exhibited type B lactic acidosis with an unknown etiology that was ultimately determined at autopsy.

Humans , Male , Female , Aged , Aged, 80 and over , Acidosis, Lactic/pathology , Lymphoma, Non-Hodgkin/pathology , Lymphoma, Large B-Cell, Diffuse/pathology , Hematologic Neoplasms , Autopsy
Article in Portuguese | LILACS | ID: biblio-1354421


Introdução: Quando exposto à quimioterapia, o paciente onco-hematológico está suscetível a várias complicações físicas e respiratórias, associadas aos efeitos colaterais dessas substâncias. Objetivo: Avaliar o impacto de força muscular respiratória quando comparada com os níveis de normalidade e sintomatologia de fadiga, durante recebimento do tratamento quimioterapêutico de pacientes onco-hematológicos. Método: Pesquisa observacional do tipo transversal, realizada por meio de questionário referente aos dados sociodemográficos e de manovacuometria com dispositivo analógico. Resultados: A pesquisa foi constituída por uma população composta de 19 pessoas, 57,9% mulheres e 42,9% homens. A idade média foi de 51,3 anos. A predominância diagnóstica foi leucemia, seguida por linfoma e mieloma. Entre as queixas, a dispneia esteve presente em 31,6% dos casos, sendo a quimioterapia o protocolo escolhido para todos os participantes. Durante a avaliação, 52,6% relataram cansaço e, entre eles, 70% relataram sentir-se melhor quando em repouso, seguidos por 50% impedidos de realizar suas atividades diárias. Ex-fumantes representaram 70% da população pesquisada e 84,2% não praticavam atividades físicas. Na amostra, 62,4% apresentaram frequência respiratória normal, predominando o padrão respiratório apical e o tórax longilíneo. Foram observados resultados significativos na diminuição de Pimáx e Pemáx, com valores estatisticamente conclusivos de p<0,001 nas duas variáveis. Conclusão: O quadro da doença, os tratamentos utilizados e as internações a que essa população foi submetida provocaram a diminuição da força muscular respiratória e o aumento dos sintomas de fadiga.

Introduction: When exposed to chemotherapy, the onco-hematological patient is susceptible to several physical and respiratory complications, associated with side effects of these substances. Objective: Evaluate the impact on respiratory muscle strength when compared to the levels of normality and symptoms of fatigue of onco-hematological patients during chemotherapy treatment. Method: Observational cross-sectional study performed trough a social demographic questionnaire and manovacuometry with analogical device. Results: The study population consisted of 19 subjects, 57.9% women and 42.9% men. The average age was 51.3 years old. The predominant diagnoses were leukemia, followed by lymphoma and myeloma. Among the complaints, dyspnea was present in 31.6% of the cases, chemotherapy was the protocol of choice for all the participants. During the evaluation, 52.6% reported tiredness, and among them, 70%, claimed they feel better when at rest, followed by 50% precluded from performing their daily activities. Ex-smokers represented 70% of the study population and 84.2% did not practice physical activities. 62.4 % of the sample presented normal respiratory frequency, with the apical breathing pattern and predominant slender thorax. Significant results were observed in decreasing MIP and MEP with statistically conclusive values of p<0.001 for the two variables. Conclusion: The disease, the treatments and the hospitalizations this population was submitted provoked the reduction of the respiratory muscle strength and increase of the fatigue symptoms

Introducción: Cuando se expone a quimioterapia, el paciente oncohematológico es susceptible a diversas complicaciones físicas y respiratorias, asociadas a los efectos secundarios de estas sustancias. Objetivo: Evaluar el impacto de la fuerza de los músculos respiratorios en comparación con los niveles de normalidad y síntomas de fatiga, mientras reciben tratamiento de quimioterapia de pacientes oncohematológicos. Método: Investigación observacional transversal, realizada mediante un cuestionario referente a datos sociodemográficos y realizando manovacuometría con dispositivo analógico. Resultados: La investigación consistió en una población compuesta por 19 personas, 57,9% mujeres y 42,9% hombres. La edad media fue de 51,3 años. El predominio diagnóstico fue la leucemia, seguida del linfoma y el mieloma. Entre las quejas, la disnea estuvo presente en el 31,6% de los casos, siendo la quimioterapia el protocolo elegido para todos los participantes. Durante la evaluación, el 52,6% refirió cansancio y, entre ellos, el 70% refirió sentirse mejor en reposo, seguido del 50% incapaz de realizar sus actividades diarias. Los exfumadores representaron el 70% de la población encuestada y el 84,2% no practicaba actividad física. En la muestra, el 62,4% tenía frecuencia respiratoria normal, con predominio de patrón respiratorio apical y tórax longilineal. Se observaron resultados significativos en la disminución de Pimax y Pmax, con valores estadísticamente concluyentes de p<0,001 en ambas variables. Conclusión: Debido a la enfermedad, los tratamientos utilizados y las hospitalizaciones a las que esta población fueron sometidos provocaron la disminución de la fuerza de los músculos respiratorios y aumento de los síntomas de fatiga

Humans , Male , Female , Middle Aged , Total Lung Capacity , Hematologic Neoplasms/drug therapy , Muscle Strength
Article in English | LILACS, BBO | ID: biblio-1287492


Abstract Objective: To analyze the distribution of childhood cancer in Brazil and the time between the diagnosis and the start of treatment, according to hospital-based cancer registries (2010-2016). Material and Methods: This was an observational descriptive study using secondary data (36,187 records) from hospital databases of the National Cancer Institute (INCA) and the Onco-center Foundation of São Paulo (FOSP). Epidemiological data were obtained, and compliance with Federal Law 12,732/12 was verified, which establishes a maximum period of 60 days to start cancer therapy after the diagnosis. Absolute and percent frequencies, central tendency and dispersion measures, and the coefficient of prevalence of childhood cancer were calculated. Results: The mean age of the pediatric patients was 9.3 years (± 6.2); 54.1% (n=19,586) of them were males; 32.0% (n=11,440) were aged 0 to 4 years; and 43.4% (n=11,338) had a self-reported mixed-race skin color. The Southeast region of Brazil accounted for 40.2% (n=14,564) of the cases, of which 63.0% (n=9,178) corresponded to solid neoplasms, as opposed to the North region, where hematological neoplasms prevailed (53.9%, n=1,535). Most registered patients aged 0 to 19 years were treated in 60 days or less (77%, n=27,929). However, for 24.0% (n = 2,207) of adolescents (15 to 19 years) this time was more than 60 days after the diagnosis. Conclusion: The characteristics related to childhood cancer varied across the Brazilian geographic regions, and most patients were properly treated within the time enforced by law.

Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Brazil/epidemiology , Hospital Information Systems/statistics & numerical data , Oncology Service, Hospital , Hematologic Neoplasms , Medical Oncology , Epidemiology, Descriptive , Data Interpretation, Statistical , Diagnosis , Observational Studies as Topic/methods
Rev. Esc. Enferm. USP ; 55: e20200270, 2021. tab, graf
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1340710


ABSTRACT Objective: To assess the domains of quality of life related to hematologic cancer patient health in the first three years from autologous and allogeneic hematopoietic stem cell transplantation. Method: A prospective cohort from September 2013 to February 2019 at a reference service in Latin America with 55 patients. The instruments Quality of Life Questionnaire Core C30 and Functional Assessment Cancer Therapy - Bone Marrow Transplantation were used. For data analysis, Generalized Linear Mixed Model was used. Results: The domains global and overall quality of life presented the lowest scores in the pancytopenia phase: 59.3 and 91.4 in autologous, 55.3 and 90.3 in allogeneic. The mixed method analysis has shown that there was a significant change in scores between the phases throughout the treatment (p< 0.05). Conclusion: Health-related quality of life presented significant changes in the domains between the phases throughout time. Understanding these results enables nursing interventions directed at the domains which were damaged during treatment.

RESUMEN Objetivo: Evaluar los dominios de la calidad de vida relacionada con la salud de pacientes con cáncer hematológico en los tres primeros años después del trasplante de células madre hematopoyéticas autólogo y alogénico. Método: Cohorte prospectivo realizado de septiembre 2013 a febrero 2019 en un servicio de referencia en Latinoamérica con 55 participantes. Se utilizaron los instrumentos Quality of Life Questionnaire Core C30 y Functional Assessment Cancer Therapy - Bone Marrow Transplantation. Para el análisis de datos, se utilizó el Generalized Linear Mixed Model. Resultados: Los dominios de calidad de vida global y general presentaran las menores puntuaciones en la etapa de pancitopenia: 59,3 y 91,4 en el autólogo, 55,3 y 90,3 en el alogénico. El análisis de métodos mixtos demostró que hubo un cambio significativo en la puntuación entre las etapas durante el tratamiento (p< 0,05). Conclusión: La calidad de vida relacionada con la salud presentó cambios significativos en los dominios entre las etapas a lo largo del tiempo. Conocer estos resultados posibilita intervenciones de enfermería direccionadas a los dominios afectados durante el tratamiento.

RESUMO Objetivo: Avaliar os domínios de qualidade de vida relacionada à saúde de pacientes com câncer hematológico nos três primeiros anos após o transplante de células-tronco hematopoéticas autólogo e alogênico. Método: Coorte prospectiva realizada de setembro de 2013 a fevereiro de 2019, em um serviço de referência na América Latina, com 55 participantes. Foram utilizados os instrumentos Quality of Life Questionnaire Core C30 e Functional Assessment Cancer Therapy - Bone Marrow Transplantation. Para análise dos dados, foi utilizado o Generalized Linear Mixed Model. Resultados: Os domínios de qualidade de vida global e geral apresentaram os menores escores na etapa de pancitopenia: 59,3 e 91,4 no autólogo, 55,3 e 90,3 no alogênico. A análise de métodos mistos demonstrou que houve alteração significativa dos escores entre as etapas ao longo do tratamento (p< 0,05). Conclusão: A qualidade de vida relacionada à saúde apresentou mudança significativa nos domínios entre as etapas ao longo do tempo. Conhecer esses resultados possibilita intervenções de enfermagem direcionadas aos domínios prejudicados durante o tratamento.

Quality of Life , Bone Marrow Transplantation , Hematopoietic Stem Cell Transplantation , Oncology Nursing , Hematologic Neoplasms
Frontiers of Medicine ; (4): 783-804, 2021.
Article in English | WPRIM | ID: wpr-922520


The current standard of care in hematological malignancies has brought considerable clinical benefits to patients. However, important bottlenecks still limit optimal achievements following a current medical practice. The genetic complexity of the diseases and the heterogeneity of tumor clones cause difficulty in ensuring long-term efficacy of conventional treatments for most hematological disorders. Consequently, new treatment strategies are necessary to improve clinical outcomes. Chimeric antigen receptor T-cell (CAR T) immunotherapy opens a new path for targeted therapy of hematological malignancies. In this review, through a representative case study, we summarize the current experience of CAR T-cell therapy, the management of common side effects, the causative mechanisms of therapy resistance, and new strategies to improve the efficacy of CAR T-cell therapy.

Hematologic Neoplasms/therapy , Humans , Immunotherapy/adverse effects , Neoplasms , Receptors, Chimeric Antigen , T-Lymphocytes
Journal of Experimental Hematology ; (6): 1365-1368, 2021.
Article in Chinese | WPRIM | ID: wpr-888568


Bromodomain-containing protein 4 (BRD4) is one of the most important members in the bromodomain and extra terminal domain(BET) family, it plays an important role in cellular physiology in human body, such as cell cycles, cell proliferation, and immune response. Recent studies have shown that BRD4 is associated with occurrence and development of acute myeloblastic leukemia, multiple myeloma and lymphoma. The mechanisms of BRD4 in hematologic malignancies including the regulation of c-Myc expression, and participation of the composition of super-enhancer, etc. At present, many kinds of inhibitors have been developed to target inhibit BRD4 for therapy in hematologic malignancies, and some of BRD4 inhibitors have entered phase Ⅱ clinical trials, which suggested that BRD4 inhibitors are expected to become new therapeutic agents for hematologic malignancies. In this review, the research advance of BRD4 and BRD4 inhibitors in hematologic malignancies was summarized briefly.

Cell Cycle Proteins , Cell Proliferation , Hematologic Neoplasms/drug therapy , Humans , Nuclear Proteins , Protein Domains , Transcription Factors
Journal of Experimental Hematology ; (6): 1360-1364, 2021.
Article in Chinese | WPRIM | ID: wpr-888567


The incidence of hematological malignant tumor is increasing year by year, and seriously affecting the human health. In addition to the traditional radiation and chemotherapy, immunotherapy has achieved a certain effect in the treatment of blood tumor, but it is limited by exhaustion of CD8

CD8-Positive T-Lymphocytes , Galectins , Hematologic Neoplasms , Hepatitis A Virus Cellular Receptor 2 , Humans , Immunotherapy
Article in Chinese | WPRIM | ID: wpr-880181


TIGIT is an inhibitory receptor containing T cell immunoglobulin and immune receptor protein tyrosine inhibitory motif domain. It shows high expression level on the surface of immune cells in tumor patients and plays an inhibitory role by binding to corresponding ligands, CD155 and CD112. Studying the mechanism of inhibitory effect of TIGIT and the way to block it shows a great significance in the immunotherapy of tumor. In this review, the structure of TIGIT molecule and its inhibitory effect on immune cells(including NK cells and T cells) were introduced, the expression level and the newest research advance of TIGIT molecule in lymphoma,multiple myeloma,leukemia and myelodysplastic syndrome were reviewed and summarized briefly, so as to provide reference for the further study of TIGIT and the application of TIGIT inhibitors in hematological malignancies.

Hematologic Neoplasms , Humans , Immune Checkpoint Proteins , Immunotherapy , Killer Cells, Natural , Receptors, Immunologic
Article in Chinese | WPRIM | ID: wpr-880073


In recent years, it is found that the classical IKKα and IKKβ pathway were closely relates with hematological tumors, except the classical pathogenesis, moreover the classical IKKβ pathway is deeply studied. The studies indicated that the IKKβis activated to phosphorylate the NF-κB through multiple cascades under the effect of extracellular IL-6, TNF-α and other stimulating factors. At the cellular level, the classical IKKβcan promote the tumor cell survival and proliferation, reduce the cell apoptosis, and promote the angiogenesis and cell transfer. Although the classical IKKα plays a role in regulating IKKβ activity, but its role in non-classical pathway is more prominent. This review briefly summarizes the latest advance of researches on the pathogenesis of hematological malignancies in term of IKKα and IKKβpathway, so as to provide the theoretic basis for deeply understanding and studying the pathogenesis of hematologic tumors. At present, blocking the classical IKKα and IKKβ pathway has become a new target for treatment of hematological tumors, moreover, some specific inhibitor for IKKα and IKKβpathway have been developed, for example, LY2409881, BMS 345541 and so on. Most of these drugs are in clinical trials and display some good anti-tumor effects.

Cell Survival , Hematologic Neoplasms , Humans , I-kappa B Kinase/metabolism , NF-kappa B/metabolism , Signal Transduction , Tumor Necrosis Factor-alpha
Article in Chinese | WPRIM | ID: wpr-880067


OBJECTIVE@#To investigate the clinical value of expression level of interleukin-2 receptor (IL-2R) and interleukin-8 (IL-8) in the fever patients with hematological malignancies.@*METHODS@#A total of 121 inpatients in the First Affiliated Hospital of Anhui Medical University from April 2018 to October 2019 were enrolled in this study. The patients were separated into infection group (61 cases) and non-infection group (60 cases). In the meantime, 40 healthy people without fever or infection in the hospital for physical examination were set as matched group. C-reactive protein (CRP), procalcitonin (PCT), and cytokines were detected in all the patients with fever after admission and infection control. While, blood samples were taken from healthy people during physical examination.@*RESULTS@#The expression levels of IL-2R in infection group were higher than those in the control group (P<0.001), and the level of serum IL-2R in infection group was also higher than that in the non-infection group (P<0.05). Based on Spearman analysis, in patients with malignant hematologic disease, serum IL-2R level was positively correlated with CRP (r=0.557, P<0.001) and IL-8 (r=0.479, P<0.001), and IL-8 level was positively correlated with CRP (r=0.318, P<0.001). Compared with the non-infection group, the area under the curve (AUC) for the level of CRP, PCT, and IL-2R of the infection group was 0.714 (95%CI: 0.623-0.806), 0.765 (95%CI: 0.680-0.851), and 0.761 (95%CI: 0.686-0.836), the sensitivity was 0.705, 0.852, and 0.705, and the specificity was 0.717, 0.70, and 0.60, respectively. While, AUC of CRP+PCT, CRP+IL-2R, PCT+IL-2R, and CRP+PCT+IL-2R was 0.789 (95%CI: 0.712-0.866), 0.702 (95%CI: 0.623-0.782), 0.757 (95%CI: 0.677-0.838), and 0.789 (95%CI: 0.712-0.866), the sensitivity was 0.738, 0.934, 0.705, and 0.738, and the specificity was 0.840, 0.470, 0.810, and 0.840, respectively.@*CONCLUSION@#CRP, PCT, IL-2R, and IL-8 are useful parameters for diagnosis of the infectious fever in patients with hematological malignancies, which provides the basis of initial diagnosis and rational use of antibioties for clinician.

Biomarkers , C-Reactive Protein , Calcitonin , Calcitonin Gene-Related Peptide , Hematologic Neoplasms , Humans , Interleukin-8 , Protein Precursors , Receptors, Interleukin-2 , Sepsis
Article in Chinese | WPRIM | ID: wpr-880065


OBJECTIVE@#To analyze the characteristics, prognosis and risk factors of bloodstream infection in patients with hematological malignancies in the tropics, so as to provide evidence for the prevention and treatment of bloodstream infection.@*METHODS@#The clinical features, blood culture results and prognosis of patients with bloodstream infection in patients with hematological malignancies admitted to Hainan Hospital of PLA General Hospital were retrospectively studied.@*RESULTS@#The most common primary infection site of the 81 patients with hematological malignancies was lung (46.91%), followed by PICC (11.11%). The detection rate of Gram-positive bacteria and Gram-negative bacteria in the blood culture was 60.98% and 30.02%, respectively. Coagulase-negative staphylococci was the most common Gram-positive bacteria resulting in bloodstream infection in our study. Of the Gram-negatives, Klebsiella pneumoniae (34.38%) was predominant, followed by Escherichia coli (18.75%) and Pseudomonas aeruginosa (18.75%). Gram-positive bacteria was highly sensitive (100%) to vancomycin, linezolid and tigecycline. Study showed that Gram-negative bacteria had low sensitive to quinolones, in particular, the resistance rate of Escherichia coli to quinolones was as high as 83.33%. In terms of overall survival (OS), the 30-days OS of patients with Gram-negative and Gram-positive septicemia was 77.42% and 92.00%, respectively. There was no statistically significant difference between the two groups. Multivariate analysis revealed that septic shock (P=0.001, RR=269.27) was an independent risk factor for 30-day mortality, and remission status (P=0.027, RR=0.114) was an independent predictor of a favourable outcome of bloodstream infection in patients with hematological malignancies.@*CONCLUSION@#Gram-positive bacteria are the main pathogens causing bloodstream infections in patients with hematological malignancies in the tropics. Improving the care of PICC is an important measure to reduce the incidence of bloodstream infection in patients with hematological malignancies in the tropics. A correct treatment relieving disease and effective prevention and treatment of septic shock can reduce mortality of patients with bloodstream infection in patients with hematological malignancies in the tropics.

Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Drug Resistance, Bacterial , Gram-Negative Bacteria , Hematologic Neoplasms/drug therapy , Humans , Microbial Sensitivity Tests , Prognosis , Retrospective Studies , Sepsis