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Discrimination of acute lymphoblastic leukemia from systemic-onset juvenile idiopathic arthritis at disease onset

TAMASHIRO, Mirian S.; AIKAWA, Nadia Emi; CAMPOS, Lucia Maria A.; CRISTOFANI, Lilian Maria; ODONE-FILHO, Vicente; SILVA, Clovis A.
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
36.62%
OBJECTIVE: To assess clinical and laboratory features that differentiate acute lymphoblastic leukemia from systemic juvenile idiopathic arthritis at disease onset. METHODS: Fifty-seven leukemia patients with musculoskeletal involvement, without blasts on peripheral blood and without glucocorticoid therapy at disease onset and 102 systemic juvenile idiopathic arthritis patients (International League of Associations for Rheumatology criteria) were retrospectively evaluated. The following features were examined: fever, rheumatoid rash, arthritis, limb pain, hepatomegaly, splenomegaly, pericarditis, myocarditis, pleuritis, weight loss, bleeding, anemia, leukopenia, neutropenia, thrombocytopenia, erythrocyte sedimentation rate, and lactic dehydrogenase levels. RESULTS: The median age at disease onset was significantly higher in leukemia patients than in those with systemic-onset juvenile idiopathic arthritis (5.8 vs. 3.8 years). In addition, the frequencies of limb pain, hepatomegaly, weight loss and hemorrhagic manifestations were significantly higher in leukemia patients than in systemic-onset juvenile idiopathic arthritis patients (70% vs. 1%, 54% vs. 32%, 30% vs. 8%, and 9% vs. 0%, respectively). Likewise, the frequencies of anemia...

ABO genotyping in leukemia patients reveals new ABO variant alleles

NOVARETTI, M. C. Z.; DOMINGUES, A. E.; MANHANI, R.; PINTO, E. M.; DORLHIAC-LLACER, P. E.; CHAMONE, D. A. F.
Fonte: FUNPEC-EDITORA Publicador: FUNPEC-EDITORA
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
36.64%
The ABO blood group is the most important blood group system in transfusion medicine and organ transplantation. To date, more than 160 ABO alleles have been identified by molecular investigation. Almost all ABO genotyping studies have been performed in blood donors and families and for investigation of ABO subgroups detected serologically. The aim of the present study was to perform ABO genotyping in patients with leukemia. Blood samples were collected from 108 Brazilian patients with chronic myeloid leukemia (N = 69), chronic lymphoid leukemia (N = 13), acute myeloid leukemia (N = 15), and acute lymphoid leukemia (N = 11). ABO genotyping was carried out using allele specific primer polymerase chain reaction followed by DNA sequencing. ABO*001 was the most common allele found, followed by ABO*022 and by ABO*A103. We identified 22 new ABO*(variants) in the coding region of the ABO gene in 25 individuals with leukemia (23.2%). The majority of ABO variants was detected in O alleles (15/60.0%). In 5 of 51 samples typed as blood group O (9.8%), we found non-deletional ABO*O alleles. Elucidation of the diversity of this gene in leukemia and in other diseases is important for the determination of the effect of changes in an amino acid residue on the specificity and activity of ABO glycosyltransferases and their function. In conclusion...

The CEBPA gene is down-regulated in acute promyelocytic leukemia and its upstream promoter, but not the core promoter, is highly methylated

SANTANA-LEMOS, Barbara Amelia; LANGE, Ana Paula Alencar de Lima; BENICIO, Mariana Tereza de Lira; JOSE, Thiago Donizete da Silva; LUCENA-ARAUJO, Antonio Roberto; KRAUSE, Alexandre; THOME, Carolina Hassibe; REGO, Eduardo Magalhaes
Fonte: FERRATA STORTI FOUNDATION Publicador: FERRATA STORTI FOUNDATION
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
36.62%
impairment of CCAAT Enhancer Binding Protein alpha (CEBPA) function is a common finding in acute myeloid leukemia; nevertheless, its relevance for acute promyelocytic leukemia pathogenesis is unclear. We analyzed the expression and assessed the methylation status of the core and upstream promoters of CEBPA in acute promyelocytic leukemia at diagnosis. Patients with acute promyelocytic leukemia (n=18) presented lower levels of CEBPA expression compared to healthy controls (n=5), but higher levels than those in acute myeloid leukemia with t(8;21) (n=9) and with inv(16) (n=5). Regarding the core promoter, we detected no methylation in 39 acute promyelocytic leukemia samples or in 8 samples from controls. In contrast, analysis of the upstream promoter showed methylation in 37 of 39 samples, with 17 patients showing methylation levels over 30%. Our results corroborate data obtained in animal models showing that CEBPA is down-regulated in acute promyelocytic leukemia stem cells and suggest that epigenetic mechanisms may be involved.; Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)[01/08693-8]; Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)[06/58136-1]

Targeting the Acute Myeloid Leukemia Stem Cells

KRAUSE, Alexandre; KRAUSE, Luciana M. Fontanari; REGO, Eduardo M.
Fonte: BENTHAM SCIENCE PUBL LTD Publicador: BENTHAM SCIENCE PUBL LTD
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
36.6%
The idea that within the bulk of leukemic cells there are immature progenitors which are intrinsically resistant to chemotherapy and able to repopulate the tumor after treatment is not recent. Nevertheless, the term leukemia stem cells (LSCs) has been adopted recently to describe these immature progenitors based on the fact that they share the most relevant features of the normal hematopoetic stem cells (HSCs), i.e. the self-renewal potential and quiescent status. LSCs differ from their normal counterparts and from the more differentiated leukemic cells regarding the default status of pathways regulating apoptosis, cell cycle, telomere maintenance and transport pumps activity. In addition, unique features regarding the interaction of these cells with the microenvironment have been characterized. Therapeutic strategies targeting these unique features are at different stages of development but the reported results are promising. The aim of this review is, by taking acute myeloid leukemia (AML) as a bona fide example, to discuss some of the mechanisms used by the LSCs to survive and the strategies which could be used to eradicate these cells.

The Aurora A and B kinases are up-regulated in bone marrow-derived chronic lymphocytic leukemia cells and represent potential therapeutic targets

Careta, Francisco de Paula; Gobessi, Stefania; Panepucci, Rodrigo Alexandre; Bojnik, Engin; de Oliveira, Fabio Morato; Matos, Daniel Mazza; Falcao, Roberto P.; Laurenti, Luca; Zago, Marco A.; Efremov, Dimitar G.
Fonte: FERRATA STORTI FOUNDATION; PAVIA Publicador: FERRATA STORTI FOUNDATION; PAVIA
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
36.65%
Background The malignant B cells in chronic lymphocytic leukemia receive signals from the bone marrow and lymph node microenvironments which regulate their survival and proliferation. Characterization of these signals and the pathways that propagate them to the interior of the cell is important for the identification of novel potential targets for therapeutic intervention. Design and Methods We compared the gene expression profiles of chronic lymphocytic leukemia B cells purified from bone marrow and peripheral blood to identify genes that are induced by the bone marrow microenvironment. Two of the differentially expressed genes were further studied in cell culture experiments and in an animal model to determine whether they could represent appropriate therapeutic targets in chronic lymphocytic leukemia. Results Functional classification analysis revealed that the majority of differentially expressed genes belong to gene ontology categories related to cell cycle and mitosis. Significantly up-regulated genes in bone marrow-derived tumor cells included important cell cycle regulators, such as Aurora A and B, survivin and CDK6. Down-regulation of Aurora A and B by RNA interference inhibited proliferation of chronic lymphocytic leukemia-derived cell lines and induced low levels of apoptosis. A similar effect was observed with the Aurora kinase inhibitor VX-680 in primary chronic lymphocytic leukemia cells that were induced to proliferate by CpG-oligonucleotides and interleukin-2. Moreover...

Molecular basis for the diagnosis and treatment of acute promyelocytic leukemia

Bassi, Sarah Cristina; Rego, Eduardo Magalhães
Fonte: Associação Brasileira de Hematologia e Hemoterapia e daSociedade Brasileira de Transplante de Medula Óssea Publicador: Associação Brasileira de Hematologia e Hemoterapia e daSociedade Brasileira de Transplante de Medula Óssea
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
36.65%
Acute promyelocytic leukemia is characterized by gene rearrangements that always involve the retinoic acid receptor alpha on chromosome 15. In the majority of patients t(15;17) is detected, which generates the promyelocytic leukemia gene/retinoic acid receptor alpha rearrangement. This rearrangement interacts with several proteins, including the native promyelocytic leukemia gene, thus causing its delocalization from the nuclear bodies, impairing its function. The immunofluorescence staining technique using the anti-PML antibody may be used to provide a rapid diagnosis and to immediately start therapy using all-trans retinoic acid. The experience of the International Consortium on Acute Promyelocytic Leukemia has demonstrated that early mortality was significantly reduced by adopting the immunofluorescence technique. All-trans retinoic acid combined with chemotherapy is the standard therapy; this promotes complete remission rates greater than 90% and cure rates of nearly 80%. However, early mortality is still an important limitation and hematologists must be aware of the importance of treating newly diagnosed acute promyelocytic leukemia as a medical emergency.

Análise morfológica, imunofenotípica e molecular na identificação da leucemia megacariocítica aguda (LMA-M7)=Morphologic, cytogenetic and molecular analyses in the identification of acute megakaryocytic leukemia (AML-M7); Morphologic, cytogenetic and molecular analyses in the identification of acute megakaryocytic leukemia (AML-M7)

Farias, Mariela Granero; Biermann, Maristela Bittencourt
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
Português
Relevância na Pesquisa
36.6%
A leucemia megacariocítica aguda (LMA-M7) é um subtipo raro de leucemia mielóide aguda (LMA) que foi recentemente incorporada na classificação Franco-Americana- Britânica (FAB). Ela representa 3% a 5% dos casos de LMA, sendo freqüentemente associada a mielofibrose e retrata um subtipo de mau prognóstico. O diagnóstico da LMA-M7 baseia-se, inicialmente, nas características morfológicas das células leucêmicas. O aspirado de medula óssea, ou biópsia, mostra uma população de células pleomórficas e basofílicas, podendo apresentar projeções citoplasmáticas (blebs). A utilização apenas de critérios morfológicos e citoquímicos não é suficiente para um diagnóstico correto, por isso faz-se necessária uma diferenciação de leucemia megacariocítica aguda com os outros subtipos de leucemia mielóide aguda, principalmente nos casos em que as células blásticas se apresentam indiferenciadas, como é o caso da leucemia mielóide aguda, minimamente diferenciada (LMA-M0), da leucemia mielóide aguda sem maturação (LMA-M1) e da leucemia linfóide aguda, subtipo L1 e L2. Sendo assim, a utilização de técnicas de imunofenotipagem é essencial para o diagnóstico diferencial, pois mostra uma população de células leucêmicas com ausência da maioria dos marcadores linfóides e mielóides de superfície...

Caracterização da expressão e função de IRS1 e IRS2 na hematopoese normal, mielodisplásica e leucêmica; IRS1 and IRS2 function and expression in normal, myelodysplastic, and leukemia hematopoiesis

João Agostinho Machado Neto
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 24/02/2011 Português
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A ocorrência da leucemia aguda resulta de uma combinação de mutações e alterações em funções protéicas que conferem a capacidade de proliferação, defeito na diferenciação e apoptose celular. Síndromes mielodisplásicas (SMD) são desordens hematopoéticas resultantes de alterações na célula pluripotente, caracterizadas por hematopoese ineficaz e alta taxa de evolução para leucemia mieloide aguda (LMA). Células leucêmicas expressam uma variedade de receptores de fatores de crescimento e citocinas, como o receptor do Insulin-like growth factor 1 (IGF-1R). A via de sinalização do IGF-1 inicia-se através da ativação de seu receptor e subsequente ativação de seus substratos, como os substratos do receptor de insulina (IRS). Algumas evidências indicam a participação das proteínas IRS em doenças hematológicas: (1) IRS1 foi descrito como constitutivamente fosforilado e associado ao BCR-ABL em células K562; (2) a expressão de IRS1 foi relacionada com pior prognóstico em leucemia linfóide aguda (LLA) BCR-ABL positiva; (3) IRS2 associa-se ao receptor de eritropoetina; (4) a expressão de IRS2 foi modulada durante estímulos com eritropoetina e IGF-1 e em processos de diferenciação em células hematopoéticas normais e leucêmicas. Neste estudo...

Influência dos polimorfismos CYP2B6 G15631T, GSTM1, GSTT1, NQO1 C609T e MDR-1 C3435T na resposta ao tratamento de leucemia aguda e síndrome mielodisplásica; Influence of polymorphisms CYP2B6 G15631T, GSTM1, GSTT1, NQO1 C609T and MDR-1 C3435T in treatment response of acute leukemia and myelodysplastic syndrome

Bruna Palodetto
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 20/01/2012 Português
Relevância na Pesquisa
36.67%
As síndromes mielodisplásicas (SMD) são um grupo heterogêneo de doenças hematopoiéticas caracterizadas pela hematopoiese ineficaz resultando em citopenia no sangue periférico; cerca de 30% das SMDs evolui para leucemia mielóide aguda secundária. Leucemias agudas (LA) são doenças malignas do sangue caracterizadas por acúmulo de blastos podendo ser classificadas em mielóide agudas (LMA), quando há envolvimento de mieloblastos, ou linfóides agudas (LLA), quando há envolvimento de linfoblastos. A sobrevida média dos pacientes com leucemia aguda ainda é muito baixa e muitos deles são resistentes ao tratamento ou apresentam recaída. O melhor entendimento sobre os mecanismos de progressão da mielodisplasia e da resposta ao tratamento em leucemias agudas poderia melhorar a taxa de resposta ao tratamento e aumentar a sobrevida dos pacientes. O metabolismo e o efluxo de drogas são mecanismos de defesa responsáveis pela proteção contra agentes tóxicos e estão envolvidos na biotransformação de diversos xenobióticos. O metabolismo de drogas pode ser divido em duas fases (Fase I: Oxidação; Fase II: Conjugação), sendo ambas mediadas por enzimas metabolizadoras de drogas. O efluxo de drogas é outro mecanismo de proteção contra tóxicos...

Infection and childhood leukemia: review of evidence

Maia,Raquel da Rocha Paiva; Wünsch Filho,Victor
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2013 Português
Relevância na Pesquisa
36.66%
OBJECTIVE : To analyze studies that evaluated the role of infections as well as indirect measures of exposure to infection in the risk of childhood leukemia, particularly acute lymphoblastic leukemia. METHODS : A search in Medline, Lilacs, and SciELO scientific publication databases initially using the descriptors “childhood leukemia” and “infection” and later searching for the words “childhood leukemia” and “maternal infection or disease” or “breastfeeding” or “daycare attendance” or “vaccination” resulted in 62 publications that met the following inclusion criteria: subject aged ≤ 15 years; specific analysis of cases diagnosed with acute lymphoblastic leukemia or total leukemia; exposure assessment of mothers’ or infants’ to infections (or proxy of infection), and risk of leukemia. RESULTS : Overall, 23 studies that assessed infections in children support the hypothesis that occurrence of infection during early childhood reduces the risk of leukemia, but there are disagreements within and between studies. The evaluation of exposure to infection by indirect measures showed evidence of reduced risk of leukemia associated mainly with daycare attendance. More than 50.0% of the 16 studies that assessed maternal exposure to infection observed increased risk of leukemia associated with episodes of influenza...

Acute leukemia in early childhood

Emerenciano,M.; Koifman,S.; Pombo-de-Oliveira,M.S.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2007 Português
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36.6%
Acute leukemia in early childhood is biologically and clinically distinct. The particular characteristics of this malignancy diagnosed during the first months of life have provided remarkable insights into the etiology of the disease. The pro-B, CD10 negative immunophenotype is typically found in infant acute leukemia, and the most common genetic alterations are the rearrangements of the MLL gene. In addition, the TEL/AML1 fusion gene is most frequently found in children older than 24 months. A molecular study on a Brazilian cohort (age range 0-23 months) has detected TEL/AML1+ve (N = 9), E2A/PBX1+ve (N = 4), PML/RARA+ve (N = 4), and AML1/ETO+ve (N = 2) cases. Undoubtedly, the great majority of genetic events occurring in these patients arise prenatally. The environmental exposure to damaging agents that give rise to genetic changes prenatally may be accurately determined in infants since the window of exposure is limited and known. Several studies have shown maternal exposures that may give rise to leukemogenic changes. The Brazilian Collaborative Study Group of Infant Acute Leukemia has found that mothers exposed to dipyrone, pesticides and hormones had an increased chance to give birth to babies with infant acute leukemia [OR = 1.48 (95%CI = 1.05-2.07)...

Molecular basis for the diagnosis and treatment of acute promyelocytic leukemia

Bassi,Sarah Cristina; Rego,Eduardo Magalhães
Fonte: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular Publicador: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2012 Português
Relevância na Pesquisa
36.65%
Acute promyelocytic leukemia is characterized by gene rearrangements that always involve the retinoic acid receptor alpha on chromosome 15. In the majority of patients t(15;17) is detected, which generates the promyelocytic leukemia gene/retinoic acid receptor alpha rearrangement. This rearrangement interacts with several proteins, including the native promyelocytic leukemia gene, thus causing its delocalization from the nuclear bodies, impairing its function. The immunofluorescence staining technique using the anti-PML antibody may be used to provide a rapid diagnosis and to immediately start therapy using all-trans retinoic acid. The experience of the International Consortium on Acute Promyelocytic Leukemia has demonstrated that early mortality was significantly reduced by adopting the immunofluorescence technique. All-trans retinoic acid combined with chemotherapy is the standard therapy; this promotes complete remission rates greater than 90% and cure rates of nearly 80%. However, early mortality is still an important limitation and hematologists must be aware of the importance of treating newly diagnosed acute promyelocytic leukemia as a medical emergency.

Laboratory diagnosis of chronic myelomonocytic leukemia and progression to acute leukemia in association with chronic lymphocytic leukemia: morphological features and immunophenotypic profile

Santos,Iris Mattos; Franzon,Carine Muniz Ribeiro; Koga,Adolfo Haruo
Fonte: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular Publicador: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2012 Português
Relevância na Pesquisa
36.67%
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...

Gene rearrangement study for minimal residual disease monitoring in children with acute lymphocytic leukemia

Assumpcao,Juliana Godoy; Paula,Francisco Danilo Ferreira; Xavier,Sandra Guerra; Murao,Mitiko; Aguirre Neto,Joaquim Caetano de; Dutra,Alvaro Pimenta; Lima,Eduardo Ribeiro; Oliveira,Benigna Maria de; Viana,Marcos Borato
Fonte: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular Publicador: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2013 Português
Relevância na Pesquisa
36.6%
OBJECTIVE To detect markers for minimal residual disease monitoring based on conventional polymerase chain reaction for immunoglobulin, T-cell receptor rearrangements and the Sil-Tal1 deletion in patients with acute lymphocytic leukemia. METHODS Fifty-nine children with acute lymphocytic leukemia from three institutions in Minas Gerais, Brazil, were prospectively studied. Clonal rearrangements were detected by polymerase chain reaction followed by homo/heteroduplex clonality analysis in DNA samples from diagnostic bone marrow. Follow-up samples were collected on Days 14 and 28-35 of the induction phase. The Kaplan-Meier and multivariate Cox methods were used for survival analysis. RESULTS Immunoglobulin/T-cell receptor rearrangements were not detected in 5/55 children screened (9.0%). For precursor-B acute lymphocytic leukemia, the most frequent rearrangement was IgH (72.7%), then TCRG (61.4%), and TCRD and IgK (47.7%); for T-acute lymphocytic leukemia, TCRG (80.0%), and TCRD and Sil-Tal deletion (20.0%) were the most common. Minimal residual disease was detected in 35% of the cases on Day 14 and in 22.5% on Day 28-35. Minimal residual disease on Day 28-35, T-acute lymphocytic leukemia, and leukocyte count above 50 x 109/L at diagnosis were bad prognostic factors for leukemia-free survival in univariate analysis. Relapse risk for minimal residual disease positive relative to minimal residual disease negative children was 8.5 times higher (95% confidence interval: 1.02-70.7). CONCLUSION Immunoglobulin/T-cell receptor rearrangement frequencies were similar to those reported before. Minimal residual disease is an independent prognostic factor for leukemia-free survival...

Discrimination of acute lymphoblastic leukemia from systemic-onset juvenile idiopathic arthritis at disease onset

Tamashiro,Mirian S.; Aikawa,Nadia Emi; Campos,Lucia Maria A.; Cristofani,Lilian Maria; Odone-Filho,Vicente; Silva,Clovis A.
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2011 Português
Relevância na Pesquisa
36.62%
OBJECTIVE: To assess clinical and laboratory features that differentiate acute lymphoblastic leukemia from systemic juvenile idiopathic arthritis at disease onset. METHODS: Fifty-seven leukemia patients with musculoskeletal involvement, without blasts on peripheral blood and without glucocorticoid therapy at disease onset and 102 systemic juvenile idiopathic arthritis patients (International League of Associations for Rheumatology criteria) were retrospectively evaluated. The following features were examined: fever, rheumatoid rash, arthritis, limb pain, hepatomegaly, splenomegaly, pericarditis, myocarditis, pleuritis, weight loss, bleeding, anemia, leukopenia, neutropenia, thrombocytopenia, erythrocyte sedimentation rate, and lactic dehydrogenase levels. RESULTS: The median age at disease onset was significantly higher in leukemia patients than in those with systemic-onset juvenile idiopathic arthritis (5.8 vs. 3.8 years). In addition, the frequencies of limb pain, hepatomegaly, weight loss and hemorrhagic manifestations were significantly higher in leukemia patients than in systemic-onset juvenile idiopathic arthritis patients (70% vs. 1%, 54% vs. 32%, 30% vs. 8%, and 9% vs. 0%, respectively). Likewise, the frequencies of anemia...

Differentiation between tuberculosis and leukemia in abdominal and pelvic lymph nodes: evaluation with contrast-enhanced multidetector computed tomography

Zhang,Ge; Yang,Zhi-gang; Yao,Jin; Deng,Wen; Zhang,Shuai; Xu,Hua-yan; Long,Qi-hua
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2015 Português
Relevância na Pesquisa
36.69%
PURPOSE: To compare the characteristics of tubercular vs. leukemic involvement of abdominopelvic lymph nodes using multidetector computed tomography (CT). MATERIALS AND METHODS: We retrospectively reviewed multidetector computed tomography features including lymph node size, shape, enhancement patterns, and anatomical distribution, in 106 consecutive patients with newly diagnosed, untreated tuberculosis (55 patients; 52%) or leukemia (51 patients; 48%). In patients with leukemia, 32 (62.7%) had chronic lymphocytic leukemia, and 19 (37.3%) had acute leukemias; of these, 10 (19.6%) had acute myeloid leukemia, and 9 (17.6%) had acute lymphocytic leukemia. RESULTS: The lower para-aortic (30.9% for tuberculosis, 63.2% for acute leukemias and 87.5% for chronic lymphocytic leukemia) and inguinal (9.1% for tuberculosis, 57.9% for acute leukemias and 53.1% for chronic lymphocytic leukemia) lymph nodes were involved more frequently in the three types of leukemia than in tuberculosis (both with p <0.017). Tuberculosis showed peripheral enhancement, frequently with a multilocular appearance, in 43 (78.2%) patients, whereas patients with leukemia (78.9% for acute myeloid leukemia and acute lymphocytic leukemia, 87.5% for chronic lymphocytic leukemia) demonstrated predominantly homogeneous enhancement (both with p <0.017). For the diagnosis of tuberculosis...

A Statistical Survey of Leukemia in Ontario and at the Ontario Cancer Foundation Clinics, 1938-1958

MacKay, E. N.; Sellers, A. H.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 24/06/1967 Português
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36.64%
In Ontario, leukemia causes about 4% of all cancer deaths, ranging from nearly 50% at under 5 years of age to 1-3% at age 50 and over. Age-specific death rates are highest among older people; at all ages, male deaths exceed female deaths. Only about 20% of all leukemia patients in Ontario are registered at Ontario Cancer Clinics; the proportion changed sharply with the advent of chemotherapy. For 1258 patients registered in 1938-1963, the crude one-year survival rate was 50%, ranging from 9% for acute leukemia to about 60% for non-acute lymphatic and myeloid leukemia. The long-term outlook was much better for non-acute lymphatic leukemia than for non-acute myeloid leukemia. For acute leukemia, the treatment of choice was chemotherapy; for non-acute lymphatic leukemia, radiotherapy was used, followed, if required, by chemotherapy or further radiotherapy. For non-acute myeloid leukemia, the advantage of chemotherapy over radiotherapy was not established.

The concurrent occurrence of Leishmania chagasi infection and childhood acute leukemia in Brazil

Vasconcelos,Gisele Moledo de; Azevedo-Silva,Fernanda; Thuler,Luiz Claudio dos Santos; Pina,Eugênia Terra Granado; Souza,Celeste S.F.; Calabrese,Katia; Pombo-de-Oliveira,Maria S.
Fonte: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular Publicador: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2014 Português
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36.67%
Objective: This study investigated the co-existence of Leishmania chagasi infection and childhood leukemia in patients naïve to treatment; this has serious clinical and epidemiological implications. Methods: The seroprevalence of L. chagasi antibodies prior to any treatment was investigated in children with clinical features of acute leukemia. Serological tests were performed in 470 samples drawn from under 14-year-old children from different regions of Brazil with clinical suspicion of acute leukemia. Acute leukemia subtypes were characterized by immunophenotyping using flow cytometry. Morphological analyses of bone marrow aspirates were systematically performed to visualize blast cells and/or the formation of L. chagasi amastigotes. Data analysis used a standard univariate procedure and the Pearson's chi-square test. Results: The plasma of 437 children (93%) displayed antibodies against L. chagasi by indirect immunofluorescence assay and enzyme-linked immunosorbent assay tests. Of the 437 patients diagnosed from 2002 to 2006, 254 had acute lymphoblastic leukemia, 92 had acute myeloid leukemia, and 91 did not have acute leukemia. The seroprevalence of L. chagasi antibodies according to the indirect immunofluorescence assay test (22.5%) was similar in children with or without acute leukemia (p-value = 0.76). The co-existence of visceral leishmanasis and acute leukemia was confirmed in 24 children. The overall survival of these children was poor with a high death rate during the first year of leukemia treatment. Conclusion: In the differential diagnosis of childhood leukemia...

Discrimination of acute lymphoblastic leukemia from systemic-onset juvenile idiopathic arthritis at disease onset

Tamashiro, Mirian S.; Aikawa, Nadia Emi; Campos, Lucia Maria A.; Cristofani, Lilian Maria; Odone-Filho, Vicente; Silva, Clovis A.
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/01/2011 Português
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36.62%
OBJECTIVE: To assess clinical and laboratory features that differentiate acute lymphoblastic leukemia from systemic juvenile idiopathic arthritis at disease onset. METHODS: Fifty-seven leukemia patients with musculoskeletal involvement, without blasts on peripheral blood and without glucocorticoid therapy at disease onset and 102 systemic juvenile idiopathic arthritis patients (International League of Associations for Rheumatology criteria) were retrospectively evaluated. The following features were examined: fever, rheumatoid rash, arthritis, limb pain, hepatomegaly, splenomegaly, pericarditis, myocarditis, pleuritis, weight loss, bleeding, anemia, leukopenia, neutropenia, thrombocytopenia, erythrocyte sedimentation rate, and lactic dehydrogenase levels. RESULTS: The median age at disease onset was significantly higher in leukemia patients than in those with systemic-onset juvenile idiopathic arthritis (5.8 vs. 3.8 years). In addition, the frequencies of limb pain, hepatomegaly, weight loss and hemorrhagic manifestations were significantly higher in leukemia patients than in systemic-onset juvenile idiopathic arthritis patients (70% vs. 1%, 54% vs. 32%, 30% vs. 8%, and 9% vs. 0%, respectively). Likewise, the frequencies of anemia...

Infection and childhood leukemia: review of evidence

Maia,Raquel da Rocha Paiva; Wunsch Filho,Victor
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2013 Português
Relevância na Pesquisa
36.66%
OBJECTIVE : To analyze studies that evaluated the role of infections as well as indirect measures of exposure to infection in the risk of childhood leukemia, particularly acute lymphoblastic leukemia. METHODS : A search in Medline, Lilacs, and SciELO scientific publication databases initially using the descriptors “childhood leukemia” and “infection” and later searching for the words “childhood leukemia” and “maternal infection or disease” or “breastfeeding” or “daycare attendance” or “vaccination” resulted in 62 publications that met the following inclusion criteria: subject aged ≤ 15 years; specific analysis of cases diagnosed with acute lymphoblastic leukemia or total leukemia; exposure assessment of mothers’ or infants’ to infections (or proxy of infection), and risk of leukemia. RESULTS : Overall, 23 studies that assessed infections in children support the hypothesis that occurrence of infection during early childhood reduces the risk of leukemia, but there are disagreements within and between studies. The evaluation of exposure to infection by indirect measures showed evidence of reduced risk of leukemia associated mainly with daycare attendance. More than 50.0% of the 16 studies that assessed maternal exposure to infection observed increased risk of leukemia associated with episodes of influenza...