Assuntos
Humanos , Pneumonia Viral/sangue , Síndrome do Desconforto Respiratório do Recém-Nascido/sangue , Infecções por Coronavirus/sangue , Betacoronavirus , Hemostasia/fisiologia , Tempo de Tromboplastina Parcial , Pneumonia Viral/complicações , Tempo de Protrombina , Síndrome do Desconforto Respiratório do Recém-Nascido/etiologia , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Fatores de Risco , Interleucinas/metabolismo , Infecções por Coronavirus , Infecções por Coronavirus/complicações , Fatores de Necrose Tumoral/metabolismo , Coagulação Intravascular Disseminada/sangue , PandemiasRESUMO
OBJECTIVES: To evaluate the effects of epoetin (EPO) alfa treatment on overall survival, event-free survival and response duration in patients with myelodysplastic syndrome (MDS) who were treated at a haematological referral centre in northeastern Brazil. METHODS: This was a retrospective cohort study of 36 patients diagnosed with MDS and treated with EPO alfa at 30,000 to 60,000 IU per week. Clinical data were collected from medical records. The events assessed were non-response to treatment and progression to acute myeloid leukaemia (AML). Statistical analyses were performed using GraphPad Prism 7 and SPSS 24 software. RESULTS: The overall survival of patients who received EPO alfa treatment was 51.64%, with a median of 65 months of treatment, and the overall survival of this group was 100% during the first 24 months. We detected a 43.5-month median event-free survival, with a response rate of 80.5%. We observed responses from 25 to 175 months. Patients with transfusion dependence and those with a high-risk stratification, as determined by the International Prognostic Scoring System (IPSS), the Revised International Prognostic Scoring System (IPSS-R), the WHO classification-based Prognostic Scoring System (WPSS) and the WHO 2016, had a lower event-free survival than other patients. CONCLUSIONS: Despite the wide use of EPO alfa in the treatment of anaemia in patients with MDS, the median response duration is approximately only 24 months. Our data provide encouraging results concerning the benefits of using EPO alfa for the improvement of the quality of life, as patients treated with EPO showed higher overall survival, event-free survival rates and longer response durations than have been previously described in the literature.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Síndromes Mielodisplásicas/mortalidade , Síndromes Mielodisplásicas/tratamento farmacológico , Epoetina alfa/uso terapêutico , Hematínicos/uso terapêutico , Contagem de Plaquetas , Valores de Referência , Fatores de Tempo , Transfusão de Sangue , Brasil , Hemoglobinas/análise , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Progressão da Doença , Estimativa de Kaplan-Meier , Cariótipo , Intervalo Livre de ProgressãoRESUMO
SUMMARY Wernick's Encephalopathy (WE) is an acute neuropsychiatric syndrome caused by thiamine deficiency post hematopoietic stem cell transplant (HSCT). WE is associated with high mortality and morbidity rates, but due to its rare occurrence, it is rarely considered in patients submitted to this procedure. Considering that, the manuscript reports the clinical characteristics and the possible factors that predisposed the occurrence of WE in a patient with non-Hodgkin's lymphoma post-Autologous HSCT. We conclude that WE should be considered in patients submitted to autologous HSCT associated with prolonged use of TPN and malnutrition.