Diagnóstico das síndromes mielodisplásicas / Diagnosis of myelodysplastic syndromes

Objetivo: discutir as recentes contribuições encontradas na literatura para o campo do diagnósticodas SMD. Método: pesquisa da literatura sobre o tema, destacando as principais ferramentasdiagnósticas disponíveis na atualidade e sua aplicação no diagnóstico complementar e de exclusãodas SMD. Considerações finais: nos últimos anos, tem havido um melhor conhecimento daetiopatogenia e características clínicas das SMD. Em virtude disso, o diagnóstico se tornou maispreciso, o que pode ter ocasionado um aumento no registro dessas desordens e não um real aumentoda incidência.

Objectives: to discuss the recent contributions found in the literature for the area on diagnosis ofthe MDS. Method: literature screening on the subject, detaching the main available diagnostictools in the present time and its application in the complementary diagnosis and of the MDSexclusion. Final considerations: currently, the knowledge on the ethiopatogeny and clinicalcharacteristics of the MDS has improved. In virtue of this, the diagnosis has become more accurate,what may have a caused an increase in the register of these disorders and not real increase of theincidence.

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.

Clínica e epidemiologia de pacientes submetidos ao transplante de medula óssea / Clinic-epidemiology of the patients suffering bone marrow transplantation

Objetivo: analisar os aspectos clínicos e epidemiológicos dos pacientes do Estado do Pará, submetidos ao transplante de medula óssea TMO. Método: estudo transversdal de prevalência de pacientes do Estado Pará, submetidos ao transplante de medula óssea, de janeiro de 2001 a julho de 2005, diagnosticados e acompanhados no Centro de Hematologia e Hemoterapia do Estado do Pará (HEMOPA) e no Hospital Ofir Loyola (HOL) em Belém-PA. Resultados: a maioria dos pacientes transplantados é proveniente da zona metropolitana de Belém; a média de idade é de 27,57 anos; a aplasia medular (28,57%) é a doença de base mais freqüente; a maioria dos TMOs foi realizada no Estado de São Paulo (60%) e a doença do enxerto contra o hospedeiro (DECH) foi a principal complicação encontrada (46,42%). Conclusão: os transplantados de medula óssea estudados, apresentam sobrevida e complicações semelhantes às encontradas em regiões mais desenvolvidas.

Objective: to analyse the clinic-epidemiology aspects of the patients from Pará suffering bone marrow transplatatioll (BMT) Method: transversal study of pacients prevalency from Pará, that suffering bone marrow transplatatioll since january of 2001 to july of 2005, that were diagnosticked and accompanied in the HEMOPA and in the HOL, in Belém city. Results: the most part of the transplanted patients is originating from towns near to Belem; the medium of age 27,57 years, the bone marrow aplasia (28,57%)is the illness more presenting. The majority was submitted to the transplant in São Paulo state and the graft-versus-host disease (GVHD) was to main complicatioll found (46,42%). Conclusion: the transplanted of bone marrow are present survival and similar complications to centers more developed.