Outcome of childhood acute lymphoblastic leukemia treatment in a single center in Brazil: A survival analysis study.

BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common neoplasm in childhood. The probability of current overall survival (OS) is around 90% in developed countries. There are few studies that demonstrate the results in Brazil. AIM: This work aims to analyze the results of children with ALL treated at a single institution in Rio de Janeiro. METHODS AND RESULTS: Retrospective analysis survival study of a cohort of childhood ALL patients treated in Hemorio. Kaplan-Meier and log-rank methods were used for the analysis of OS and events-free survival (EFS) and the Cox proportional hazards regression model for multivariate analysis. The probability of OS and EFS at 6 years was 52% and 45%. The probability of OS and EFS in 6 years for patients aged 10-17 years was 31% and 28% and for the younger was 65% and 55%, respectively (p < .001). A probability of OS and EFS in 6 years for patients with more than 100 000 leukocytes/mm3 at diagnosis was 19% and 16% and those with less than 100 000 were 62% (p = .007) and 55% (p = .008). Those who received less than 10 doses of native Escherichia coli asparaginase had a probability of OS and EFS in 6 years of 27% and 21% and those who received at least 10 doses were 74% and 65% (p < .001). CONCLUSIONS: The presence of a high number of adolescents and high-risk patients, as well as many patients who discontinued the use of asparaginase or any substitute led to a lower probability of OS and EFS in our cohort.

Biphasic regulation of type II phosphatidylinositol-4 kinase by sphingosine: cross talk between glycero- and sphingolipids in the kidney.

Phosphatidylinositol-4 kinase (PI-4K) is responsible for the generation of phosphatidylinositol-4 phosphate (PtdIns(4)P), a bioactive signaling molecule involved in several biological functions. In this study, we show that sphingosine modulates the activity of the PI-4K isoform associated with the basolateral membranes (BLM) from kidney proximal tubules. Immunoblotting with an anti-α subunit PI-4K polyclonal antibody revealed the presence of two bands of 57 and 62kDa in the BLM. BLM-PI-4K activity retains noteworthy biochemical properties; it is adenosine-sensitive, not altered by wortmanin, and significantly inhibited by Ca(2+) at the µM range. Together, these observations indicate the presence of a type II PI-4K. Endogenous phosphatidylinositol (PI) alone reaches PI-4K half-maximal activity, revealing that even slight modifications in PI levels at the membrane environment promote significant variations in BLM-associated-PI-4K activity. ATP-dependence assays suggested that the Mg.ATP(2-) complex is the true substrate of the enzyme and that free Mg(2+) is an essential cofactor. Another observation indicated that higher concentrations of free ATP are inhibitory. BLM-associated-PI-4K activity was ~3-fold stimulated in the presence of increasing concentration of sphingosine, while in concentrations higher than 0.4mM, in which S1P is pronouncedly formed, there was an inhibitory effect on PtdIns(4)P formation. We propose that a tightly coupled regulatory network involving phosphoinositides and sphingolipids participate in the regulation of key physiological processes in renal BLM carried out by PI-4K.

Diacylglycerol kinase activity in purified basolateral membranes of kidney tubules. I. Evidence for coupling with phospholipase C.

The diacylglycerol kinase (DGK) catalyzes the phosphorylation of diacylglycerol (DAG) yielding phosphatidic acid (PA) signaling molecules which are involved in the modulation of different cell responses. The aim of this work was to characterize the DGK activity associated to the basolateral membranes (BLM) of kidney proximal tubules, in a native preparation that preserves the membrane microenvironment. The Arrhenius plot of DGK activity was non-linear, indicating a complex influence of the lipid environment of the native membrane. The formation of PA was strongly impaired by U73122, an inhibitor of PLC, whereas remained unmodified when exogenous DAG or PLC were added. The Mg.ATP2- complex is the true phosphoryl-donor substrate, and the very narrow peak of activation at pH 7.0 suggests that amino acids that dissociate at this pH, i.e. hystidine residues, play a role by acting in the coordination of the Mg2+ atoms. The renal DGK is almost completely blocked by 0.1 mM sphingosine, but it is insensitive to micromolar free Ca2+ concentrations and to R59499, the most potent inhibitor of the classical DGKs. Taken as a whole, these data suggest that the DGK isoform present in BLM of proximal tubules is different from those included in the type I family, and that membranous PLC could be the main source of DAG for DGK catalysis.