The Cost of Pediatric Unrelated HSCT

Instituto de Oncologia Pediátrica, São Paulo, BrazilBone Marrow Transplantation, Instituto de Oncologia Pediátrica - GRAACC - Unifesp, São Paulo, BrazilInstituto de Oncologia Pediátrica - GRAACC - UnifespAssociação da Medula Óssea - AMEOCell Processing Laboratory, Instituto de Oncologia Pediátrica, São Paulo, BrazilTransplante de Medula Óssea, Instituto de Oncologia Pediatrica, São Paulo, SP, BrazilInstituto de ONcologia Pediátrica - GRAACC – UnifespBone Marrow Transplantation, Instituto de Oncologia Pediátrica - GRAACC - Unifesp, São Paulo, BrazilInstituto de Oncologia Pediátrica - GRAACC - UnifespTransplante de Medula Óssea, Instituto de Oncologia Pediatrica, São Paulo, SP, BrazilInstituto de Oncologia Pediátrica - GRAACC – UnifespWeb of Scienc

Timely Capture of Relevant Data for CIBMTR

Clinical Research Center, Instituto de Oncologia Pediátrica, São Paulo, BrazilCell Processing Laboratory, Instituto de Oncologia Pediátrica, São Paulo, BrazilInstituto de Oncologia Pediátrica, São Paulo, BrazilPediatric Bone Marrow Transplantation Center, Instituto de Oncologia Pediatrica, São Paulo, BrazilWeb of Scienc

Kinetics of Circulating Plasma Cell-Free DNA in Paediatric Classical Hodgkin Lymphoma

Levels of plasma cell-free DNA (cfDNA) of a large series of children with classical Hodgkin lymphoma (cHL) were evaluated and analyzed at diagnosis and during chemotherapy treatment in relation with clinical characteristics. CfDNA levels in cHL patients were significantly higher compared with controls (p=0.002). CfDNA at diagnosis was correlated with presence of B symptoms (p=0.027) and high erythrocyte sedimentation rate (p=0.049). We found that the increasing of plasma cfDNA after first chemotherapy cycle seems to be associated with a worse prognosis (p=0.049). Levels of plasma cfDNA might constitute an interesting non-invasive tool in cHL patients' management

First Ex-Vivo Validation of a Radioguided Surgery Technique with beta- Radiation

Purpose: A radio-guided surgery technique with beta- -emitting radio-tracers was suggested to overcome the effect of the large penetration of gamma radiation. The feasibility studies in the case of brain tumors and abdominal neuro-endocrine tumors were based on simulations starting from PET images with several underlying assumptions. This paper reports, as proof-of-principle of this technique, an ex-vivo test on a meningioma patient. This test allowed to validate the whole chain, from the evaluation of the SUV of the tumor, to the assumptions on the bio-distribution and the signal detection. Methods: A patient affected by meningioma was administered 300 MBq of 90Y-DOTATOC. Several samples extracted from the meningioma and the nearby Dura Mater were analyzed with a beta- probe designed specifically for this radio-guided surgery technique. The observed signals were compared both with the evaluation from the histology and with the Monte Carlo simulation. Results: we obtained a large signal on the bulk tumor (105 cps) and a significant signal on residuals of $\sim$0.2 ml (28 cps). We also show that simulations predict correctly the observed yields and this allows us to estimate that the healthy tissues would return negligible signals (~1 cps). This test also demonstrated that the exposure of the medical staff is negligible and that among the biological wastes only urine has a significant activity. Conclusions: This proof-of-principle test on a patient assessed that the technique is feasible with negligible background to medical personnel and confirmed that the expectations obtained with Monte Carlo simulations starting from diagnostic PET images are correct.Comment: 17 pages, 4 Figs, Accepted by Physica Medic

A non-invasive approach to monitor chronic lymphocytic leukemia engraftment in a xenograft mouse model using ultra-small superparamagnetic iron oxide-magnetic resonance imaging (USPIO-MRI).

This work was supported by: Associazione Italiana Ricerca sul Cancro (AIRC) [Grant 5 x mille n.9980, (to M.F., F.M. and A. N.)]; AIRC I.G. [n. 14,326 (to M.F.)], [n.10136 and 16,722 (A.N.)], [n.15426 (to F.F.)]. AIRC and Fondazione CaRiCal co-financed Multi Unit Regional Grant 2014 [n.16695 (to F.M.)]. Italian Ministry of Health 5 × 1000 funds (to F.F). A.G R. was supported by Associazione Italiana contro le Leucemie-Linfomi-Mielomi (AIL) Cosenza - Fondazione Amelia Scorza (FAS). S.M. C.M., F.V., L. E., S. B., were supported by AIRC.Peer reviewedPostprin

Research to improve surgical oncological care on the surgical department, Maputo Central Hospital

Objetivo: No sentido de avaliar e implementar um programa de qualidade nos cuidados especializados prestados aos doentes oncológicos, que necessitam de intervenções cirúrgicas no Departamento Cirúrgico do Hospital Central de Maputo (HCM), o maior hospital de Moçambique, conduzimos a presente investigação. Avaliámos os recursos cirúrgicos, habilidades da equipe de oncologia cirúrgica, identificamos e caracterizamos as neoplasias malignas prevalentes e o conhecimento global em oncologia e oncologia cirúrgica dos nossos proficionais. O objectivo ultimo era o de desenvolver um currículo abrangente e adequado para um prrograma de formação em oncologia cirúrgica para o Hospital e para Moçambique. Metodologia: O primeiro estudo, realizado em 2017, tinha como objectivo inventariar os recursos e incluiu o preenchimento por parte dos cirurgiões de um questionário (Avaliação das Unidades de oncologia para países africanos de baixa ou média renda – anexo II), foram visitadas as àreas hospitalares associadas aos cuidados oncológicos (serviço de oncologia, UTI, sala de operações, etc.)e coletadas informações de acordo com o questionário “Avaliação da Capacidade em Oncologia Cirúrgica dos Países Africanos de Língua Oficial Portuguesa” (PSAC-Cirurgia - anexo III). No segundo estudo, realizado em 2018, avaliou-se retrospectivamente os registros de doentes com cancro do HCM. As neoplasias malignas prevalentes foram identificadas e caracterizadas (anexo IV). O conhecimento global dos residentes em oncologia e oncologia cirúrgica, foi avaliado por meio de um teste de conhecimentos preenchido de forma anónima e sem prévio aviso (anexo V). Os domínios abordados foram: Bases da oncologia, Radioterapia, Patologia, Quimioterapia, Tratamento da dor, Oncologia cirúrgica e Percurso clínico. O terceiro estudo, feito realizado em 2019. Com recurso à metodologia Delphi modificada (3 etapas). Participaram 23 especialistas em oncologia que trabalham em Moçambique incluindo oncologistas cirúrgicos. Na primeira rodada, os participantes responderam a um questionário sobre o conteúdo do currículo, o momento e local do treinamento. E foi produzido um rascunho do curriculo. Na segunda etapa, o rascunho do curriculo foi apresentada a uma amostra selecionada de especialistas nacionalmente reconhecidos em oncologia e oncologia cirúrgica, incluindo membros do Colégio Moçambicano de Cirurgiões e líderes do Ministério da Saúde. Na etapa final, para um consenso mais amplo, foi exposto o curriculo a um grande numero de especialistas em Oncologia cirurgica presente na reuniao da Aortic que decorreu em Novembro de 2019 em Maputo. foi discutida a versão final do programa de treino em oncologia cirúrgica. Obteve-se consenso sobre o currículo de treinamento em oncologia cirúrgica para Moçambique. Resultados: O cancro da mama, do esófago e colorretal foram os tumores malignos mais comumente tratadas no HCM (departamento de Cirurgias). Uma série de necessidades técnicas e de recursos, bem como as lacunas de conhecimento e habilidades, foram identificadas. Todos os cirurgiões reconheceram a necessidade de criar um programa de treinamento em oncologia ao nível da graduação, e um treino específico para residentes e educação oncológica continuada para cirurgiões gerais, para aprimorar a prática da oncologia cirúrgica. Foi produzido o prgrama de formação em Oncologia Cirúrgica. Os princípios básicos de oncologia e princípios básicos de oncologia cirúrgica devem ser incluídos no currículo da residência cirúrgica em Moçambique. Uma sub-especialização de 24 meses em Oncologia Cirúrgica deve ocorrer após a residência na área cirúrgica e a ter lugar no Hospital Central de Maputo, devendo incluir estágios em centros oncológicos de renome e familiares. A proposta final do programa tem a seguinte estrutura: a - componentes teóricas; b - duração; c - localização; d - metodologia; e - habilidades técnicas em oncologia; e f - competência e atenção especial às doenças oncológicas prevalentes em Moçambique.Purpose: Regarding adequate care for oncological patients, requiring surgical interventions at the Surgical Department of Maputo Central Hospital (MCH), the largest hospital in Mozambique, the aim of those studies, was first to assess the surgical resources, surgical oncology team skills, identify and characterize prevalent cancers treated and general knowledge in oncology and surgical oncology, expecting the development of a comprehensive curriculum in surgical oncology fellowship fit for the Hospital and all Mozambique country. Methods: The study 1, done in 2017, was based on surgeons questionnaire (The Cancer Units Assessment Checklist for low- or middle-income African countries (annex I), visiting the unities (oncology service, ICU, operations room, etc.) collecting information according to the Portuguese-speaking African Countries Assessment of Surgical Oncology Capacity Survey (PSAC-Surgery – annex II). The study 2, done in 2018, by retrospective analysis of individual cancer patient registries of MCH, the prevalent cancers has been identified and characterized (annex IV). And the general knowledge in oncology and surgical oncology, this issue was evaluated by simple test administered anonymously and without prior notice to all surgeons and residents at the Surgical Department (annex V). The domains was about basis of Oncology, Radiotherapy, Pathology, Chemotherapy, Pain management, Surgical oncology and Clinical pathway. The study 3, done in 2019, a three-round modified-Delphi approach was implemented to obtain consensus on surgical oncology training curriculum. The participants were purposefully selected 23 experts in surgical oncology working in Mozambique. In round one, participants answered a questionnaire regarding the content of the curriculum and the timing and venue of training. Draft of the curriculum was produced. In round 2, answers from the first round and the curriculum draft were presented to a purposeful selected sample of nationally recognized experts in oncology and surgical oncology, including members of the Mozambican College of Surgeons and leadership of the Ministry of Health. A final round was carried out to discuss the final version of the training program in surgical oncology with extensive participation of majority of african experts in surgical oncology (Aortic, Maputo). Results: Breast, esophagus and colorectal cancers were the most commonly treated neoplasms in MCH (at Surgical department). A range of technical and resource needs as well as the gaps in knowledge and skills were identified. All surgeons recognized the need to create a training program in oncology at the undergraduate level, specific training for residents and continuing oncological education for general surgeons, to improve the practice of surgical oncology. Basic principles of oncology and basic principles of surgical oncology should be included in the curriculum of surgical residency in Mozambique, a 24-months fellowship in surgical oncology should take place after residency in the surgical field and should occur at Maputo Central Hospital and at comprehensive cancer centers. The final proposal for the program was divided into the following structure: a – theoretical components; b - duration; c - location; d - methodology; e - technical skills in oncology; and f - competency and paid particular attention to the oncological diseases prevalent in Mozambique

Quality of life and symptom intensity over time in people with cancer receiving palliative care : results from the international European Palliative Care Cancer Symptom study

Background People with advanced cancer experience multiple symptoms during their illness trajectory, which can fluctuate in intensity. Aim To describe the course of self-reported quality of life, emotional functioning, physical functioning and symptom intensity over time in cancer patients receiving palliative care. Design Longitudinal study with monthly assessments, using the EORTC QLQ-C15-PAL. Data were analysed (1) prospectively, from baseline to >= 8-month follow-up; and (2) retrospectively, by taking death as index date and comparing results from three cross-sectional subsamples at different stages of illness (time to death >= 6, 5-3 and 2-0 months). Linear mixed models were calculated. Setting/participants A total of 1739 patients (mean age 66, 50% male) from 30 palliative care centers in 12 countries were included. Results In prospective analyses, quality of life, functioning and symptoms-except nausea/vomiting-remained generally stable over time. In retrospective analyses, patients 2-0 months before death reported significantly lower quality of life and physical functioning scores than those 5-3 months before death, who in turn scored lower than those >= 6 months before death, suggesting progressive decline. Emotional functioning remained initially unchanged, but decreased in the last months. Pain, fatigue and appetite loss showed a stable increase in intensity towards death. Dyspnea, insomnia and constipation increased from 5-3 to 2-0 months before death. Nausea/vomiting only increased when comparing those >= 6 months before death with those 2-0 months before death. Conclusion While the prospective approach showed predominantly stable patterns for quality of life, functioning and symptom severity throughout study duration, retrospective analyses indicated that deterioration was already apparent before the terminal phase and accelerated close to death. Our findings support the importance of early symptom identification and treatment in this population, and highlight the need for further studies to explore what characterizes those with either lower or higher symptom burden at different time points towards death

Effects of miRNA-15 and miRNA-16 expression replacement in chronic lymphocytic leukemia : implication for therapy

This work was supported by: Associazione Italiana Ricerca sul Cancro (AIRC) Grant 5 x mille n.9980, (to M.F., F.M. A. N., P.T. and M.N.) ; AIRC I.G. n. 14326 (to M.F.), n.10136 and 16722 (A.N.), n.15426 (to F.F.). AIRC and Fondazione CaRiCal co-financed Multi Unit Regional Grant 2014 n.16695 (to F.M.). Italian Ministry of Health 5x1000 funds (to S.Z. and F.F). A.G R. was supported by Associazione Italiana contro le Leucemie-Linfomi-Mielomi (AIL) Cosenza - Fondazione Amelia Scorza (FAS). S.M. C.M., M.C., L.E., S.B. were supported by AIRC.Peer reviewedPostprin

Population Pharmacokinetic Study of a Test Dose Busulfan Patients Undergoing Hematopoietic Stem Cell Transplantation

UNIFESP (Universidade Federal de São Paulo), BrazilOnco-Hematology Unit, Instituto da Criança - HC - FMUSP, Sao Paulo, BrazilHospital Israelita Albert Einstein, BrazilHematology and Bone Marrow Transplantation Dept, Hospital Israelita Albert Einstein, BrazilHematology and Bone Marrow Transplantation Dept, UNIFESP (Universidade Federal de Sao Paulo), BrazilPediatric Bone Marrow Transplantation Center, Instituto de Oncologia Pediatrica, São Paulo, BrazilHematology and Bone Marrow Transplantation Dept, Hospital Israelita Albert Einstein, Sao Paulo, BrazilInstituto de Oncologia Pediátrica, São Paulo, BrazilClinical Research Center, Instituto de Oncologia Pediátrica, São Paulo, BrazilDepartment of Medicine - Bone Marrow Transplant Program, Case Western Reserve University, ClevelandUNIFESP (Universidade Federal de São Paulo), BrazilHematology and Bone Marrow Transplantation Dept, UNIFESP (Universidade Federal de Sao Paulo), BrazilWeb of Scienc