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Id: lil-765558
Autor: Rosselli, Diego; Díaz, Carlos Eduardo; Gutiérrez, Laura.
Título: Desenlaces clínicos en hematoncología: diez años de investigaciones en Pubmed / Clinical outcomes in Hemato-Oncology: Ten year Pubmed literature review
Fonte: Rev. colomb. cancerol;19(2):95-102, abr.-jun. 2015. ilus, tab.
Idioma: es.
Resumo: Objetivo: Determinar cuáles son los desenlaces clínicos empleados en los estudios fase III de tratamiento de neoplasias hematoncológicas y qué proporción de ellos emplean supervivencia global como desenlace primario. Método: Mediante una búsqueda en Pubmed, analizar todos los experimentos clínicos aleatorios publicados en los últimos 10 años, de tratamientos de novo, en población adulta. Resultados: La búsqueda inicial arrojó 310 referencias, entre las que se seleccionaron 90 estudios clínicos. La enfermedad más estudiada fue mieloma múltiple, con 29 estudios, seguida de linfoma no Hodgkin, con 26. Las otras fueron: leucemia mieloide aguda (12), leucemia linfocítica crónica (10), leucemia mieloide crónica (8), síndromes mielodisplásicos (3) y linfoma de Hodgkin (2). En 20 estudios (22%) se empleó la supervivencia global como desenlace primario (en solo 3 de ellos alcanzó significación estadística), en 37 más (41%) se agrupó con otros desenlaces para conformar un desenlace compuesto. En 55 estudios (61%) la supervivencia global fue un desenlace secundario. Conclusiones: Aunque la supervivencia global es el estándar de oro en terapia oncológica, los desenlaces agrupados u otros, como tiempo libre de enfermedad o indicadores paraclínicos de actividad de la enfermedad, son más empleados, quizá por ser buenos predictores y requerir muestras y seguimientos menores. Su capacidad para predecir supervivencia global (en algunos casos calidad de vida) debe ser validada. Solo en las formas más agresivas de cáncer se justifica usar de rutina la supervivencia global como el desenlace primario.

Objective: To describe the clinical outcomes used in phase III studies in Hematology-Oncology malignancies, and to determine what proportion use overall survival as the primary outcome. Methods: Using a systematic literature search in PubMed, an analysis was made of phaseIII randomized clinical trials with de novo treatments of hematology-oncological neoplasias in adult populations published in the last 10 years. Results: The initial search yielded 310 references, 90 of which were finally selected. The overall survival rate was used in 20 studies (22%) as the primary outcome (in 3 of them it reached statistical significance). Grouped intermediate outcomes were used in 37 others (41%). As a secondary outcome the overall survival rate was used in 55 studies (61%). Among the intermediate outcomes used were, response rates, disease-free or relapse-free survival rates, and progression-free survival rate. Multiple myeloma was the most studied disease, with 29 studies (32%), followed by non-Hodgkin lymphoma (28%). Conclusions: Although overall survival rate is the gold standard in cancer therapy, it is not the most often used outcome. Intermediate outcomes, such as disease-free survival or biomarkers are often good predictors, and require smaller samples and less follow-up time. Nevertheless, their predictive capacity for overall survival rate (or, in some cases, quality of life) should also be assessed. The use of the overall survival rate as the routine primary outcome is only justified in the most aggressive forms of cancer.
Descritores: Linfoma não Hodgkin
Doença de Hodgkin
Leucemia Linfocítica Crônica de Células B
Leucemia Mielogênica Crônica BCR-ABL Positiva
Leucemia Mieloide Aguda
PubMed
Mieloma Múltiplo
-População
Qualidade de Vida
Terapêutica
Biomarcadores
Doença
Taxa de Sobrevida
Adulto
Menores de Idade
Métodos
Limites: Humanos
Tipo de Publ: Revisão
Responsável: CO40.1 - Biblioteca Médica


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Id: biblio-915118
Autor: Saaed, Hiwa K; Mahmood, Matin A; Khoshnaw, Najmaddin.
Título: Quantitative real time PCR analysis of apoptotic gene expression in chronic lymphocytic leukemia patients and their relationships with chemosensitivity
Fonte: Appl. cancer res;37:1-7, 2017. tab, ilus.
Idioma: en.
Resumo: Background: Apoptosis-related gene expression such as BCL2, and p53 has been suggested in predicting the patient response to chemo- or radiotherapy, as well as patient's survival. Methods: The aim of this study was to determine changes in BCL2 and p53 apoptosis related gene expressions in chronic lymphocytic leukemia (CLL) patients in response to different chemotherapy regimens and number of treatment courses. The study was conducted on 55 CLL patients (44 CLL and 11 CLL/SLL; small lymphocytic lymphoma) and 40 healthy individuals as control, over three-months period. The RNA was extracted by exploitation total RNA extraction kit, treated with DNAse, then cDNA was synthesized and qRT-PCR used to analyze antiapoptotic BCL2 and tumor suppresser p53 gene expressions. Results: CLL/SLL showed higher BCL2 and p53 gene expression than CLL. The patients with CLL showed three-fold increase in BCL2 gene expression compared to healthy controls (p < 0.05), and 50% decrease in p53 gene expressions (p < 0.05). BCL2 gene expression was higher, particularly, for those who were treated with higher range of treatment courses and combination of fludarabine, cyclophosphamide and rituximab (FCR) regimen. P53 gene expression reciprocally related with BCL2 and vice versa. Conclusions: In contrary to BCL2, p53 gene was extremely expressed in patients treated with chemotherapy agents, particularly after 24­30 months disease duration; suggesting a late expression of p53 during advanced stages of the disease. A proportional change in BCL2 and p53 gene expression was reported with different treatment regimens; Chlorambucil (Clb) decreased and FCR regimen increased BCL2 gene expression. Higher p53 gene expression reported with the Chlorambucil + (Chlorambucil + Prednisolone) regimen (AU)
Descritores: Leucemia Linfocítica Crônica de Células B
Leucemia
Expressão Gênica
Genes p53
Apoptose
Genes bcl-2
Quimiorradioterapia
Limites: Humanos
Masculino
Feminino
Responsável: BR30.1 - Biblioteca


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Texto completo SciELO Brasil
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Id: biblio-983754
Autor: Carneiro, Clívia Maria Moraes de Oliveira; Bittencourt, Maraya de Jesus Semblano; Anjos, Andressa Bocalon dos; Brito, Fernanda Cecilia de Oliveira Costa Ataide.
Título: Atypical presentation of cutaneous herpes simplex virus in a patient with chronic lymphocytic leukemia
Fonte: An. bras. dermatol;94(1):111-113, Jan.-Feb. 2019. graf.
Idioma: en.
Descritores: Leucemia Linfocítica Crônica de Células B/virologia
Simplexvirus
Herpes Simples/patologia
Imunocompetência
-Biópsia
Resultado do Tratamento
Epiderme/patologia
Herpes Simples/tratamento farmacológico
Limites: Humanos
Feminino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Carta
Responsável: BR1.1 - BIREME


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Id: biblio-837930
Autor: Brasileiro, Ana; Lencastre, André; João, Alexandre; Fidalgo, Ana.
Título: Cutaneous leukemic infiltration following varicella - a case of Wolf's isotopic response
Fonte: An. bras. dermatol;91(5,supl.1):72-75, Sept.-Oct. 2016. graf.
Idioma: en.
Resumo: Abstract Wolf's isotopic response designates the appearance of two subsequent unrelated dermatoses in the same anatomic location. We report the case of a 51-year-old man with a medical history of chronic lymphocytic leukemia without known extra-hematopoietic involvement. The patient developed a disseminated papulo-vesiculous eruption, diagnosed as varicella. Few days after recovering, an erythematous and violaceous papular dermatosis with histopathological examination compatible with leukemic infiltration appeared on the scars of previous herpetic lesions. Complete remission was obtained under systemic corticotherapy, without cutaneous recurrence or blastic transformation. Wolf's isotopic response is attributed to a localized immunologic imbalance following a certain stimulus. In this patient, herpetic infection acted as a local spur for inaugural cutaneous leukemic infiltration, with no impact on the prognosis for the underlying disease.
Descritores: Pele/patologia
Leucemia Linfocítica Crônica de Células B/patologia
Varicela/patologia
Dermatopatias Virais/patologia
Infiltração Leucêmica/patologia
-Imuno-Histoquímica
Leucemia Linfocítica Crônica de Células B/tratamento farmacológico
Varicela/tratamento farmacológico
Resultado do Tratamento
Dermatopatias Virais/tratamento farmacológico
Infiltração Leucêmica/tratamento farmacológico
Derme/patologia
Herpes Zoster/patologia
Limites: Humanos
Masculino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Rego, Eduardo Magalhäes
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Id: biblio-898932
Autor: Furtado, Felipe Magalhães; Scheucher, Priscila Santos; Santana, Bárbara Amélia; Zanette, Dalila Lucíola; Calado, Rodrigo do Tocantins; Rego, Eduardo Magalhães; Matos, Daniel Mazza; Falcão, Roberto Passetto.
Título: Comparison of microRNA expression in high-count monoclonal B-cell lymphocytosis and Binet A chronic lymphocytic leukemia
Fonte: Rev. bras. hematol. hemoter;39(3):237-243, July-Sept. 2017. tab, graf.
Idioma: en.
Projeto: Conselho Nacional de Desenvolvimento Cientifico e Tecnologico.
Resumo: Abstract Background Evidence suggests that monoclonal B-cell lymphocytosis precedes all chronic lymphocytic leukemia cases, although the molecular mechanisms responsible for disease progression are not understood. Aberrant miRNA expression may contribute to the pathogenesis of chronic lymphocytic leukemia. The objective of this study was to compare miRNA expression profiles of patients with Binet A chronic lymphocytic leukemia with those of subjects with high-count monoclonal B-cell lymphocytosis and healthy volunteers (controls). Methods Twenty-one chronic lymphocytic leukemia patients, 12 subjects with monoclonal B-cell lymphocytosis and ten healthy volunteers were enrolled in this study. Flow cytometry CD19+CD5+-based cell sorting was performed for the chronic lymphocytic leukemia and monoclonal B-cell lymphocytosis groups and CD19+ cells were sorted to analyze the control group. The expressions of miRNAs (miR-15a, miR-16-1, miR-29b, miR-34a, miR-181a, miR-181b and miR-155) were determined by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR). Results Significant differences between the expressions in the chronic lymphocytic leukemia and monoclonal B-cell lymphocytosis groups were restricted to the expression of miR-155, which was higher in the former group. A comparison between healthy controls and monoclonal B-cell lymphocytosis/chronic lymphocytic leukemia patients revealed higher miR-155 and miR-34a levels and lower miR-15a, miR-16-1, miR-181a and miR-181b in the latter group. Conclusions Our results show a progressive increase of miR-155 expression from controls to monoclonal B-cell lymphocytosis to chronic lymphocytic leukemia. The role of miR-155 in the development of overt chronic lymphocytic leukemia in individuals with monoclonal B-cell lymphocytosis must be further analyzed.
Descritores: Teste de Stanford-Binet
Linfócitos B
Leucemia Linfocítica Crônica de Células B
MicroRNAs
Linfocitose
Limites: Humanos
Responsável: BR408.1 - Biblioteca da Faculdade de Medicina - BFM


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Id: lil-640876
Autor: Santos, Iris Mattos; Franzon, Carine Muniz Ribeiro; Koga, Adolfo Haruo.
Título: Laboratory diagnosis of chronic myelomonocytic leukemia and progression to acute leukemia in association with chronic lymphocytic leukemia: morphological features and immunophenotypic profile
Fonte: Rev. bras. hematol. hemoter;34(3):242-244, 2012. ilus.
Idioma: en.
Resumo: Chronic myelomonocytic leukemia is a clonal stem cell disorder that is characterized mainly by absolute peripheral monocytosis. This disease can present myeloproliferative and myelodysplastic characteristics. According to the classification established by the World Health Organization, chronic myelomonocytic leukemia is inserted in a group of myeloproliferative/myelodysplastic disorders; its diagnosis requires the presence of persistent monocytosis and dysplasia involving one or more myeloid cell lineages. Furthermore, there should be an absence of the Philadelphia chromosome and the BCR/ABL fusion gene and less than 20% blasts in the blood or bone marrow. Phenotypically, the cells in chronic myelomonocytic leukemia can present myelomonocytic antigens, such as CD33 and CD13, overexpressions of CD56 and CD2 and variable expressions of HLA-DR, CD36, CD14, CD15, CD68 and CD64. The increase in the CD34 expression may be associated with a transformation into acute leukemia. Cytogenetic alterations are frequent in chronic myelomonocytic leukemia, and molecular mutations such as NRAS have been identified. The present article reports on a case of chronic myelomonocytic leukemia, diagnosed by morphologic and phenotypical findings that, despite having been suggestive of acute monocytic leukemia, were differentiated through a detailed analysis of cell morphology. Furthermore, typical cells of chronic lymphocytic leukemia were found, making this a rare finding.
Descritores: Leucemia Linfocítica Crônica de Células B
Leucemia Mielomonocítica Aguda
Leucemia Mielomonocítica Crônica
Limites: Humanos
Idoso
Tipo de Publ: Relatos de Casos
Responsável: BR408.1 - Biblioteca da Faculdade de Medicina - BFM


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Id: biblio-1020995
Autor: Rogers, Thomas S; Gardner, Juli-Anne; Devitt, Katherine A.
Título: High-grade B-Cell lymphoma with MYC and BCL6 rearrangements associated with Richter transformation of chronic lymphocytic leukemia
Fonte: Autops. Case Rep;9(3):e2019090, July-Sept. 2019. ilus, graf.
Idioma: en.
Resumo: Richter transformation (RT), or Richter syndrome, is defined as the transformation of chronic lymphocytic leukemia (CLL) to an aggressive B-cell lymphoma. The vast majority, up to 99%, transform into diffuse large B-cell lymphoma (DLBCL), with a small subset (<1%) becoming classical Hodgkin lymphoma. Approximately half of RT cases progress through a pathway involving dysregulation of C-MYC. High-grade B-cell lymphoma (HGBL) is a recent diagnostic category of aggressive B-cell lymphomas set forth in the updated 2017 WHO Classification of Hematopoietic and Lymphoid Tissues. HGBL with MYC and BCL2 and/or BCL6 rearrangements, formerly "double-hit" and "triple-hit" lymphomas, comprise the majority of HGBL cases. Patients with HGBL have a worse prognosis than those with diffuse large B-cell lymphoma. We present a case of RT with rearrangements of MYC and BCL6. To our knowledge, there are no reported cases of RT with a "double-hit" lymphoma genotype.
Descritores: Linfoma Difuso de Grandes Células B/patologia
-Linfoma não Hodgkin
Leucemia Linfocítica Crônica de Células B
Citogenética
Limites: Humanos
Masculino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Conferência Clínica
Responsável: BR26.7 - Serviço de Biblioteca e Documentação Científica


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Id: biblio-960440
Autor: Duque Estrada, Lidia; Betancourt Reyes, Gilberto Lázaro; Betancourt Betancourt, Gilberto de Jesús; Junco Bonet, Miguel Damián.
Título: Leucemia linfocítica crónica con infiltración ocular / Chronic lymphocytic leukemia with eye infiltration
Fonte: Rev. cuba. hematol. inmunol. hemoter;33(4):85-91, oct.-dic. 2017. ilus.
Idioma: es.
Resumo: La incidencia de la leucemia linfocítica crónica (LLC) aumenta progresivamente con la edad; aproximadamente el 75 por ciento de los casos presentan 60 años o más. Este tipo de leucemia es más frecuente en varones y se desconoce su causa, existen casos que son de origen hereditario. Se presenta el caso de un paciente con el diagnóstico de LLC con infiltración ocular. Paciente blanco, masculino de 76 años de edad con antecedentes de salud de haber sido diagnosticado con LLC desde hace 5 años que se trata con Leukeran (Clorambucil) (2mg) 2 tabletas en el almuerzo y 3 tab en la comida, así como de prednisona (5mg) 1 cada 8 horas solo cuando está descompensado. Hace alrededor de 3 días comenzó con astenia, anorexia, mareos, dolor e inflamación del párpado superior derecho. El examen físico, la biopsia del párpado superior y el frotis de sangre revelaron la presencia de una recaída hematológica de la LLC con infiltración ocular(AU)

The incidence of chronic lymphocytic leukemia (CLL) increases progressively with age, approximately 75 percent of cases present 60 years or more. This type of leukemia is more frequent in men and its cause is unknown, there are cases that are of hereditary origin. A clinical case of a patient with the diagnosis of Chronic Lymphocytic Leukemia with ocular infiltration is presented. A 76-year-old white male patient with a health history of having been diagnosed with a Chronic Lymphocytic Leukemia for 5 years who is treated with Leukeran (Chlorambucil) ( 2mg) 2 tab at lunch and 3 at night; and prednisone (5mg) 1 tab every 8 hours. About 3 days ago begins with asthenia, anorexia, dizziness, pain and swelling of the upper right eyelid. Physical examination, upper eyelid biopsy and blood smears reveal the presence of a hematological relapse with ocular infiltration(AU)
Descritores: Leucemia Linfocítica Crônica de Células B/complicações
Leucemia Linfocítica Crônica de Células B/epidemiologia
Manifestações Oculares
-Doenças Palpebrais/complicações
Limites: Humanos
Masculino
Idoso
Tipo de Publ: Relatos de Casos
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: biblio-1010189
Autor: Galvano, Camila; Dos Santos, Patricia; Stanganelli, Carmen; Slavutsky, Irma.
Título: Mutaciones del gen NOTCH1 en la leucemia linfocítica crónica / NOTCH1 gene mutations in chronic lymphocytic leukemia
Fonte: Salud(i)ciencia (Impresa) = Salud(i)ciencia (En linea);23(4):332-338, mar. 2019. tab, graf.
Idioma: es.
Resumo: Chronic lymphocytic leukemia (CLL) is the most common leukemia in the Western world. The disease has\r\na highly variable clinical course, ranging from very indolent cases to patients with aggressive and rapidly\r\nprogressing outcome. Genetic studies are useful tools in analyzing this pathology, and have been incorporated in international risk classifications. The analysis of genomic rearrangements and the mutational status of immunoglobulin heavy chain variable have allowed risk groups of high prognostic value to be established. More recently, next generation sequencing studies have identified novel somatic mutations that could explain the wide clinical variability of this pathology. Among them, the analysis of NOTCH1 (neurogenic locus notch homolog protein 1) gene mutations are of interest, as deregulation is associated with tumorigenesis. NOTCH11 mutations are mostly located at exon 34 (80% of cases) and 3´UTR (untranslated region). They produce premature stop codons that produce a constitutively active and stable NOTCH1 protein. NOTCH1 mutations are associated with adverse prognosis and refractoriness to treatment. The aim of this study was to analyze NOTCH1 mutations in CLL patients by ASO-PCR and sequencing. Our results found 4.4% of cases with NOTCH1 mutated values concordant with international observations (5%-10%). Including them in the genetic status of CLL patients allows the characterization of risk groups, an aspect of great importance in clinical practice and therapeutic decisions, to be refined.

La leucemia linfocítica crónica (LLC) es la leucemia más frecuente en adultos de Occidente. Presenta\r\nun curso clínico altamente variable, con pacientes que requieren tratamiento inmediato y otros con un curso indolente de la enfermedad. Los estudios genéticos constituyen herramientas de suma utilidad en esta enfermedad, encontrándose incorporados a las clasificaciones de riesgo internacionales. El análisis de los rearreglos genómicos y del estado mutacional de los genes IGHV (immunoglobulin heavy chain variable region) ha hecho factible establecer grupos de riesgo de alto valor pronóstico. Más recientemente, estudios de secuenciación de última generación permitieron la detección de mutaciones\r\nsomáticas previamente desconocidas en esta afección, que podrían explicar la amplia variabilidad clínica\r\nobservada en la LLC. Entre ellas, resultan de interés las observadas en el gen NOTCH1 (neurogenic locus notch homolog protein 1), cuya desregulación se asocia con el desarrollo tumoral. Estas mutaciones se acumulan en mayor medida en el exón 34 (80% de los casos) y en la región 3´UTR (untraslated region), lo que genera codones de terminación prematuros que originan una proteína NOTCH1 constitutivamente activa y más estable, los cuales se asocian con pronóstico adverso y refractariedad al tratamiento. Nuestro objetivo fue evaluar mutaciones de NOTCH1 en nuestros pacientes mediante ASO-PCR y secuenciación. Se detectaron mutaciones en el 4.4% de los casos, valor concordante con los datos internacionales (5% a 10%). Su inclusión en la caracterización genética de los pacientes con LLC permitirá refinar la categorización de los grupos de riesgo, aspecto de suma importancia tanto en el seguimiento clínico como en la toma de decisiones terapéuticas.
Descritores: Leucemia Linfocítica Crônica de Células B
Citogenética
Receptor Notch1
Mutação/genética
Limites: Humanos
Tipo de Publ: Revisão
Responsável: AR392.1 - Biblioteca


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Id: lil-764217
Autor: Matos, Daniel Mazza; Furtado, Felipe Magalhães; Falcão, Roberto Passetto.
Título: Monoclonal B-cell lymphocytosis in individuals from sporadic (non-familial) chronic lymphocytic leukemia families persists over time, but does not progress to chronic B-cell lymphoproliferative diseases
Fonte: Rev. bras. hematol. hemoter;37(5):292-295, Sept.-Oct. 2015. tab, graf.
Idioma: en.
Resumo: BACKGROUND: Monoclonal B-cell lymphocytosis is classified as 'high-count or clinical' monoclonal B-cell lymphocytosis and 'low-count or population' monoclonal B-cell lymphocytosis. Previously, 167 first-degree relatives pertaining to sporadic (non-familial) chronic lymphocytic leukemia families were studied and the presence of seven monoclonal B-cell lymphocytosis individuals was reported.OBJECTIVE: The aim of this report is to describe the outcomes of five of the original monoclonal B-cell lymphocytosis individuals.METHODS: Flow cytometry analysis was performed on mononuclear cells previously isolated from peripheral blood samples. A strategy of sequential gating designed to identify the population of CD19+/CD5+ B-lymphocytes was used and, subsequently, the monoclonal B-cell lymphocytosis cells were characterized by the CD20weak/CD79bweak/negative phenotype.RESULTS: The monoclonal B-cell lymphocytosis clone showed consistent stability over time with little variations in size. After a median follow-up of 7.6 years, none of the five monoclonal B-cell lymphocytosis individuals progressed to chronic lymphocytic leukemia or other B-cell lymphoproliferative disease.CONCLUSIONS: The data of this study suggest that chronic lymphocytic leukemia-like monoclonal B-cell lymphocytosis detected in the context of sporadic chronic lymphocytic leukemia families is not prone to clinical evolution and could be just a sign of immune senescence.
Descritores: Linfócitos B
Leucemia de Células B
Leucemia Linfocítica Crônica de Células B
Relações Familiares/etnologia
Citometria de Fluxo
Linfocitose
Transtornos Linfoproliferativos
Anticorpos Monoclonais
Limites: Humanos
Responsável: BR408.1 - Biblioteca da Faculdade de Medicina - BFM



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