Influence of late treatment on how chronic myeloid leukemia responds to imatinib

INTRODUCTION: In Brazil, patients with chronic myeloid leukemia (CML) in the chronic phase were not given first-line imatinib treatment until 2008. Therefore, there was a long period of time between diagnosis and the initiation of imatinib therapy for many patients. This study aims to compare the major molecular remission (MMR) rates of early versus late imatinib therapy in chronic phase CML patients. METHODS: Between May 2002 and November 2007, 44 patients with chronic phase CML were treated with second-line imatinib therapy at the Hematology Unit of the Ophir Loyola Hospital (Belém, Pará, Brazil). BCR-ABL transcript levels were measured at approximately six-month intervals using quantitative polymerase chain reaction. RESULTS: The early treatment group presented a 60 percent probability of achieving MMR, while the probability for those patients who received late treatment was 40 percent. The probability of either not achieving MMR within one year of the initiation of imatinib therapy or losing MMR was higher in patients who received late treatment (79 percent), compared with patients who received early treatment (21 percent, odds ratio=5.75, P=0.012). The probability of maintaining MMR at 30 months of treatment was 80 percent in the early treatment group and 44 percent in the late treatment group (P=0.0005). CONCLUSIONS: For CML patients in the chronic phase who were treated with second-line imatinib therapy, the probability of achieving and maintaining MMR was higher in patients who received early treatment compared with those patients for whom the time interval between diagnosis and initiation of imatinib therapy was longer than one year.

Deficiência do crescimento: características antropométricas de crianças, e de seus pais, em atendimento ambulatorial / Growth disorder: antropometry of the children and your mother and father

Os autores descrevem os resultados da avaliaçäo de 316 crianças referidas ao Ambulatório de Baixa Estatura do Departamento de Pediatria da Escola Paulista de Medicina, sendo 235 (74,4 por cento) de Baixa Estatura (BE) e 81 (25,6 por cento) em Zona de Vigilância do Crescimento(ZV). Estas crianças foram analisadas segundo a idade, faixa etária, sensibilizaçäo, antopometria ao nascimento e dos pais. Notaram-se 30,9 (por cento) de Baixo Peso (BP) e 37,2 (por cento) de Peso Inadequado (PI) ao nascimento, entre as crianças de BE. Nos casos em ZV, 23,8 (por cento) eram de BP e 38,1 (por cento) de PI. Com relaçäo ao comprimento de nascimento notou-se que, nos casos de BE, 62,1 (por cento) eram menores de 48,5 cm e, entre aquelas em ZV, 52,8 (por cento) também apresentavam comprimento menor que 48,5 cm, que, comparadas à antropometria do recém-nascido brasileiro, apresentavam diferenças significantes. A antropometria dos pais destas crianças mostra características específicas, de modo que, associada à de nascimento, pode ser considerada como fator de risco para a BE, principalmente nos casos diagnosticados como de causa familiar e/ou constitucional