The evolution of the Revista Brasileira de Hematologia e Hemoterapia to meet the challenges of a new era

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Iron deficiency and protection of blood donors

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Chronic Myeloid Leukemia National Consensus Meeting

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Hematological abnormalities in patients chronically exposed to benzene. An update

A study was carried out into the hematological abnormabilities of peripheral blood bone marrow in patients chronically exposed to benzene. The metabolic biotransformation and the mechanisms involved in toxicity are described. Hematological data are described and discussed. Macrocytosis and lymphopenia are the earlieste hematological signs of benzene toxicity. Bone marrow abnormabilities are demostrated by the complementary methods of cytology and histology. Global hypocellularity was mainly due to the granulocytic series. Mastocytosis, eosinophilia and magakariocytic abnormalities are also presented. Inflamatory abnormalities and signs of dismyelopoiese could also be observed. The importance of peripheral blood abnormalities and the need for a critical approach to this important public health problem are emphasized.Foram apresentadas as alterações hematológicas do sangue periférico e da medula óssea em pacientes expostos cronicamente ao benzeno. Foram descritos a biotransformação metabólica e os possíveis mecanismos envolvidos neste tipo de toxicidade. Os dados hematológicos do sangue periférico são mostrados e avaliados em sua importância, sendo a macrocitose e a linfocitopenia sinais precoces de toxicidade ao benzeno. As alterações da medula óssea observadas são demonstradas pelos métodos complementares citológico e histológico. A anormalidade histológica de maior importância foi a hipocelularidade global devida principalmente ao setor granulocítico. Foi observado também aumento do percentual de eosinófilos, de mastócitos e de atipias no setor megacariocítico. Foram observadas alterações de caráter inflamatório e ressaltada a presença de sinais de dismielopoiese. Foram enfatizadas a necessidade da valorização das alterações hematológicas do sangue periférico e a visão critica e global desse importante problema de saúde pública.14515

Estudo comparativo entre sorologia, antigenemia e reação em cadeia da polimerase para o monitoramento da infecção por citomegalovírus em pacientes receptores de transplantes de células progenitoras hematopoéticas

Forty-six allogeneic hematopoietic stem cell transplantation (HSCT) patients were monitored for the presence of CMV antibodies, CMV-DNA and CMV antigens after transplantation. Immunoenzymatic serological tests were used to detect IgM and the increase in CMV IgG antibodies (increase IgG), a nested polymerase chain reaction (N-PCR) was used to detect CMV-DNA, and an antigenemia assay (AGM) was used to detect CMV antigens. The presence of CMV-IgM and/or CMV-increase IgG antibodies was detected in 12/46 (26.1%) patients, with a median time between HSCT and the detection of positive serology of 81.5 days. A positive AGM was detected in 24/46 (52.2%) patients, with a median time between HSCT and antigen detection of 62 days. Two or more consecutive positive N-PCR results were detected in 32/46 (69.5%) patients, with a median time between HSCT and the first positive PCR of 50.5 days. These results confirmed that AGM and mainly PCR are superior to serology for the early diagnosis of CMV infection. Six patients had CMV-IgM and/or CMV-increase IgG with a negative AGM (five cases) or N-PCR assay (one case). In five of these cases the serological markers were detected during the first 100 days after HSCT, the period of highest risk. These findings support the idea that serology may be useful for monitoring CMV infections in HSCT patients, especially when PCR is unavailable.Quarenta e seis pacientes receptores de transplantes de células progenitoras hematopoéticas (TCPH) foram monitorados em relação à infecção ativa por citomegalovírus (CMV). Testes sorológicos imunoenzimáticos foram utilizados para a detecção de anticorpos IgM e elevação significativa das concentrações de anticorpos IgG (aumento IgG), nested-PCR (N-PCR) foi utilizada para a detecção de CMV-DNA e antigenemia (AGM) para a detecção de antígenos virais. A presença de CMV-IgM e/ou CMV-aumento IgG foi detectada em 12/46 (26,1%) pacientes, sendo o tempo mediano entre o transplante e a detecção dos marcadores sorológicos de 81,5 dias; AGM positiva foi detectada em 24/46 (52,2%) pacientes, sendo o tempo mediano entre o transplante e a detecção de antígenos virais de 62 dias. Dois ou mais resultados positivos consecutivos de N-PCR foram detectados em 32/46 (69,5%) pacientes, sendo o tempo mediano entre o transplante e o primeiro teste positivo de 50,5 dias. Esses resultados confirmaram que a AGM e principalmente a PCR são superiores à sorologia, com relação ao diagnóstico da infecção pelo CMV. Seis pacientes apresentaram reações CMV-IgM positivas e/ou CMV-aumento IgG com reações negativas de AGM (cinco casos) ou N-PCR (um caso). Em cinco desses casos, os marcadores sorológicos foram detectados nos 100 primeiros dias após o transplante, considerado o período de maior risco. Esses resultados indicam que os testes sorológicos podem ser úteis no monitoramento da infecção por CMV após o transplante de células progenitoras hematopoéticas, principalmente quando a N-PCR não for disponível

Hematological abnormalities in patients chronically exposed to benzene. An update

A study was carried out into the hematological abnormabilities of peripheral blood bone marrow in patients chronically exposed to benzene. The metabolic biotransformation and the mechanisms involved in toxicity are described. Hematological data are described and discussed. Macrocytosis and lymphopenia are the earlieste hematological signs of benzene toxicity. Bone marrow abnormabilities are demostrated by the complementary methods of cytology and histology. Global hypocellularity was mainly due to the granulocytic series. Mastocytosis, eosinophilia and magakariocytic abnormalities are also presented. Inflamatory abnormalities and signs of dismyelopoiese could also be observed. The importance of peripheral blood abnormalities and the need for a critical approach to this important public health problem are emphasized.Foram apresentadas as alterações hematológicas do sangue periférico e da medula óssea em pacientes expostos cronicamente ao benzeno. Foram descritos a biotransformação metabólica e os possíveis mecanismos envolvidos neste tipo de toxicidade. Os dados hematológicos do sangue periférico são mostrados e avaliados em sua importância, sendo a macrocitose e a linfocitopenia sinais precoces de toxicidade ao benzeno. As alterações da medula óssea observadas são demonstradas pelos métodos complementares citológico e histológico. A anormalidade histológica de maior importância foi a hipocelularidade global devida principalmente ao setor granulocítico. Foi observado também aumento do percentual de eosinófilos, de mastócitos e de atipias no setor megacariocítico. Foram observadas alterações de caráter inflamatório e ressaltada a presença de sinais de dismielopoiese. Foram enfatizadas a necessidade da valorização das alterações hematológicas do sangue periférico e a visão critica e global desse importante problema de saúde pública

Monitoramento sorológico de uma infecção toxoplásmica após transplante de células progenitoras hematopoiéticas

We report a primary response to Toxoplasma gondii following a hematopoietic stem cell transplantation in a patient with multiple myeloma. The primary response to T. gondii was supported by IgM, IgG and IgA seroconversion. The patient was promptly treated and there were no complications related to toxoplasmosis in the subsequent months.Esse relato de caso descreve uma resposta primária ao Toxoplasma gondii após transplante de células progenitoras hematopoiéticas em paciente com mieloma múltiplo. A resposta primária para o T. gondii foi evidenciada pela soroconversão observada na resposta de anticorpos IgM, IgG e IgA. O paciente foi prontamente tratado e complicações relacionadas à toxoplasmose não foram observadas nos meses subseqüentes

Serological Monitoring Of A Toxoplasma Infection After Hematopoietic Stem Cell Transplantation.

We report a primary response to Toxoplasma gondii following a hematopoietic stem cell transplantation in a patient with multiple myeloma. The primary response to T. gondii was supported by IgM, IgG and IgA seroconversion. The patient was promptly treated and there were no complications related to toxoplasmosis in the subsequent months.52225-

Treatment Outcome of Acute Promyelocytic Leukemia with Modified Aida Protocol

We analyzed the outcome of a series of 19 newly diagnosed patients with acute promyelocytic leukemia treated with AIDA modified protocol, using mitoxantrone in place of idarubicin. Eleven patients achieved morphologic CR (58%). The remaining 8 patients had induction failure due to death during induction. Ten of eleven patients in CR achieved molecular remission after induction therapy and all the 8 patients had molecular remission after consolidation. Eight patients completed the three consolidation courses as scheduled and then proceeded to maintenance therapy. After a median follow up of 52 months, no molecular or hematological relapse has occurred. The 4-year disease-free survival is 82%. The study showed the antileukemic efficacy of mitoxantrone and that it could be used as a reasonable option in anthracycline-based strategies in APL

Association Between Human Leukocyte Antigens And Graft-versus-host Disease Occurrence After Allogenic Hematopoietic Stem Cell Transplantation.

Graft-versus-host disease (GVHD) is one of the complications following allogenic stem cell transplantation. This study investigated an association between human leukocyte antigen (HLA) and the occurrence of acute and chronic GVHD in patients who had received stem cell transplantations from HLA-identical siblings. Retrospective study at Hematology and Hemotherapy Center, Universidade Estadual de Campinas (Unicamp). The participants were 176 patients whose first transplant was between 1997 and 2009. HLA genotyping was performed serologically and using the polymerase chain reaction with specific primer sequence. Acute GVHD was positively associated with HLA-A10 (P = 0.0007), HLA-A26 (P = 0.002), B55 (P = 0.001), DRB1*15 (P = 0.0211) and DQB1*05 (P = 0.038), while HLA-B16 (P = 0.0333) was more frequent in patients without acute GVHD. Chronic GVHD was positively associated with HLA-A9 (P = 0.01) and A23 (P = 0.0292) and negatively with HLA-A2 (P = 0.0031) and B53 (P = 0.0116). HLA-B35 (P = 0.0373), B49 (P = 0.0155) and B55 (P = 0.0024) were higher in patients with acute GVHD grade 3 or above, than in other patients. In patients with extensive chronic GVHD, HLA-A9 (P = 0.0004), A24 (P = 0.0059) and A26 (P = 0.0411) were higher than in other patients, while HLA-A2 was lower (P = 0.0097). This study suggests that HLA can influence the incidence and severity of acute and chronic GVHD. However, a study with a better design and more patients will be needed to confirm these results.130219-2