The World Health Organisation Classification Of Myelodysplastic Syndromes Contains Prognostically Relevant Information Beyond The Prognostic Scores Ipss-r Or Wpss

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Comments On The Paper "c-erbb-2 Expression And Nuclear Pleomorphism In Canine Mammary Tumors"

[No abstract available]382141143Dutra, A.P., Granja, N.V.M., Schmitt, F.C., Cassali, G.D., C-erbB-2 expression and nuclear pleomorphism in canine mammary tumors (2004) Brazilian Journal of Medical and Biological Research, 37, pp. 1673-1681Clark, T.G., Bradburn, M.J., Love, S.B., Altman, D.G., Survival Analysis Part I: Basic concepts and first analyses (2003) British Journal of Cancer, 89, pp. 232-238Engelman, D.E.S., Andrade, L.A.L.A., Vassallo, J., Human papillomavirus infection and p53 protein expression in vulvar intraepithelial neoplasia and invasive squamous cell carcinoma (2003) Brazilian Journal of Medical and Biological Research, 36, pp. 1159-1165Sredni, S.T., Zerbini, M.C.N., Latorre, M.R., Alves, V.A.F., P53 as a prognostic factor in adrenocortical tumors of adults and children (2003) Brazilian Journal of Medical and Biological Research, 36, pp. 23-27Batista, S.S., Pires, R.S., Britto, L.R.G., Differential expression of AMPA-type glutamate receptor subunits during development of the chick optic tectum (2002) Brazilian Journal of Medical and Biological Research, 35, pp. 973-978Brenna, S.M.F., Zeferino, L.C., Pinto, G.A., Souza, R.A., Andrade, L.A.L.A., Vassalo, J., Martinez, E.Z., Syrjänen, K.J., C-Myc protein expression is not an independent prognostic predictor in cervical squamous cell carcinoma (2002) Brazilian Journal of Medical and Biological Research, 35, pp. 425-430Mazumdar, M., Glassman, J.R., Categorizing a prognostic variable: Review of methods, code for easy implementation and applications to decision-making about cancer treatments (2000) Statistics in Medicine, 19, pp. 113-132Clark, T.G., Bradburn, M.J., Love, S.B., Altman, D.G., Survival Analysis Part IV: Further concepts and methods in survival analysis (2003) British Journal of Cancer, 89, pp. 781-786Mazumdar, M., Smith, A., Bacik, J., Methods for categorizing a prognostic variable in a multivariable setting (2003) Statistics in Medicine, 22, pp. 559-571Streiner, D.L., Breaking up is hard to do: The heartbreak of dichotomizing (2002) Canadian Journal of Psychiatry, 47, pp. 262-266Donadieu, J., Auclerc, M.F., Baruchel, A., Prognostic study of continuous variables (white blood cell count, peripheral blast cell count, haemoglobin level, platelet count and age) in childhood acute lymphoblastic leukaemia. Analysis of a population of 1545 children treated by the French Acute Lymphoblastic Leukaemia Group (FRALLE) (2000) British Journal of Cancer, 83, pp. 1617-1622Taylor, J.M.G., Yu, M.G., Bias and efficiency loss due to categorizing an explanatory variable (2002) Journal of Multivariate Analysis, 83, pp. 248-263Metze, K., Methodological aspects of prognostic factor studies: Some caveats (1998) São Paulo Medical Journal, 116, pp. 1787-1788Metze, K., Methodological problems of grading tumour regression: Responders compared to non-responders (1998) Journal of Cancer Research and Clinical Oncology, 124, pp. 281-282Lorand-Metze, I., Pinheiro, M.P., Ribeiro, E., de Paula, E.V., Metze, K., Factors influencing survival in myelodysplastic syndromes in a Brazilian population: Comparison of FAB and WHO classifications (2004) Leukemia Research, 28, pp. 587-594Figueiras, A., Cadarso-Suarez, C., Application of nonparametric models for calculating odds ratios and their confidence intervals for continuous exposures (2001) American Journal of Epidemiology, 154, pp. 264-275Vassallo, J., Metze, K., Traina, F., de Souza, C.A., Lorand-Metze, I., The prognostic relevance of apoptosis-related proteins in classical Hodgkin's lymphomas (2003) Leukemia and Lymphoma, 44, pp. 483-488Metze, K., Souza Filho, W., Adam, R.L., Lorand-Metze, I., Analysis of the component "tree" as a new tool for analytical cellular pathology (2001) Analytical Cellular Pathology, 22, p. 65. , (Abstract)Metze, K., Adam, R.L., Silva, P.V., De Carvalho, R.B., Leite, N.J., Analysis of chromatin texture by Pinkus' approximate entropy (2004) Cytometry, 59 A (PART A), p. 63. , (Abstract)Adam, R.L., Leite, N.J., De Carvalho, R.B., Silva, P.V., Metze, K., Granulometric residues as a diagnostic tool in cytology (2004) Cytometry, 59 A (PART A), p. 63. , (Abstract)Adam, R.L., Ribeiro, E., Metze, K., Leite, N.J., Lorand-Metze, I., Morphometric and granulometric features of erythroblasts as a diagnostic tool of hematologic diseases (2004) Cytometry, 59 A (PART A), p. 46. , (Abstract

Melhorando o diagnóstico diferencial entre síndromes mielodisplásicas e citopenias periféricas reativas por citometria de fluxo multiparamétrica: o papel dos precursores de células B

Immunophenotyping is a valuable ancillary technique for the differential diagnosis between myelodysplastic syndromes (MDS) with low bone marrow (BM) blast counts and a normal karyotype, and reactive peripheral (PB) cytopenias. Our aim was to search for the most important variables for this purpose. We also analyzed the age variation of BM B-cell precursors (BCP) and its differences in reactive and clonal cytopenias. Immunophenotypic analyzes were performed in BM of 54 patients with MDS (76% with BM blasts 55 years. % BM BCP could be calculated by the formula: (-7.97 × log age) + (4.24 × log % CD34 (+) cells) - (0.22 x nr. alterations CD34 (+) cells) + 0.577. Corrected R(2) = 0.467. Analysis of myelomonocytic precursors and CD34(+) cells was satisfactory for the differential diagnosis between reactive PB cytopenias and MDS. The most specific alterations were found in CD34(+) cells. Comparison of the values obtained with those of normal age-matched controls is recommended. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1975931809154663.Immunophenotyping is a valuable ancillary technique for the differential diagnosis between myelodysplastic syndromes (MDS) with low bone marrow (BM) blast counts and a normal karyotype, and reactive peripheral (PB) cytopenias. Our aim was to search for th104419FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO25924846sem informaçãoFAEPEX (proc 1208/11 Fundo de Pesquisa da Universidade de Campinas) e Fundação MDS (concessão de Jovem Investigador Tito Bastianello 2009). Konradin Metze e Irene Lorand-Metze têm uma bolsa de pesquisa do CNPq (proc. 307270 / 2010-6 e 302277 / 2009-9, re

Comments On The Paper C-erbb-2 Expression And Nuclear Pleomorphism In Canine Mammary Tumors"."

38141-3; discussion 144-

Utilidade clínica de escala de qualidade de vida durante o tratamento quimioterápico de cães com tumor venéreo transmissível canino (TVTC) com vincristina

The clinical utility of a life quality score during vincristine chemotherapy of dogs with canine transmissible venereal tumor (CTVT) was investigated using 93 tumor-bearing dogs in this prospective study. At diagnosis, clinical data and the performance status were evaluated according to a modified Karnofsky score (CKS) adapted for dogs. The animals were treated with vincristine sulphate (0.025mg/kg) at weekly intervals until the tumor had macroscopically disappeared. The time until the first adverse event and death were recorded. In a pilot study, CKS revealed a high inter-observer concordance (kappa=0.735; weighted kappa=0.835). CKS permitted a detailed monitoring of adverse effects during therapy. Cox regressions showed that low performance score and reduced body weight were independent predictive factors for death during chemotherapy. The modified Karnofsky performance score is a simple and reproducible clinical instrument, able to estimate patient outcome after treatment of CTVT.Investigou-se a utilidade clínica de uma escala de qualidade de vida durante o tratamento quimioterápico de cães com tumor venéreo transmissível canino (TVTC) em 93 animais com TVTC que compuseram este estudo prospectivo. Ao diagnóstico, foram avaliados os dados clínicos e o escore de qualidade de vida adaptado para cães (CKS). Os animais foram tratados com sulfato de vincristina (0.025mg/kg) semanalmente até o desaparecimento macroscópico do tumor. Foram anotados o tempo até o aparecimento do primeiro evento adverso e a morte. Em estudo piloto do CKS, alta concordância entre os observadores foi demonstrada (kappa = 0.735; weighted kappa = 0.835). O CKS permitiu um detalhado monitoramento dos eventos adversos durante a terapia. A regressão Cox multivariada demonstrou que o baixo escore de qualidade de vida e o reduzido peso corporal foram fatores preditivos independentes para o óbito durante a quimioterapia. A escala modificada de Karnofsky é um instrumento clínico simples e reproduzível, hábil em estimar os efeitos do tratamento no TVTC.10861093Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Umbilical cord blood cd34(+) stem cells and other mononuclear cell subtypes processed up to 96 h from collection and stored at room temperature maintain a satisfactory functionality for cell therapy

Background and ObjectivesUmbilical cord blood (UCB) is a good stem cell source for cell therapy. We recently demonstrated that cord blood mononuclear cell (MNCs) subtypes were viable and functional until 96h after collection, even stored at room temperature. Now, we analyzed the viability and functionality of the cells before and after cryopreservation. Materials and MethodsTwenty UCB units were analyzed at 24 and 96h after collection, frozen for 6months, thawed and re-evaluated. MNCs were analyzed by flow cytometry, viability by 7-AAD and clonogenic assays (CFU) were performed. ResultsAfter 96h of storage, no substantial loss of MNC was found (median 7320x10(6)x6305x10(6)). Percentage and viability CD34(+) cells, B-cell precursors and mesenchymal stem cells were not affected. However, mature B and T lymphocytes as well as granulocytes had a substantial loss. CFU growth was observed in all samples. Prefreezing storage of 96h was associated with a relative loss of colony formation (median 12%). Postthaw, this loss had a median of 49% (24h samples) to 56% (96h samples). ConclusionThe delay of 96h before UCB processing is possible, without a prohibitive impairment of CD34(+) loss in number and functionality.Umbilical cord blood (UCB) is a good stem cell source for cell therapy. We recently demonstrated that cord blood mononuclear cell (MNCs) subtypes were viable and functional until 96h after collection, even stored at room temperature. Now, we analyzed the10817281sem informaçãosem informaçã

Fractal Characteristics of May-Grünwald-Giemsa Stained Chromatin Are Independent Prognostic Factors for Survival in Multiple Myeloma

The use of computerized image analysis for the study of nuclear texture features has provided important prognostic information for several neoplasias. Recently fractal characteristics of the chromatin structure in routinely stained smears have shown to be independent prognostic factors in acute leukemia. In the present study we investigated the influence of the fractal dimension (FD) of chromatin on survival of patients with multiple myeloma.We analyzed 67 newly diagnosed patients from our Institution treated in the Brazilian Multiple Myeloma Study Group. Diagnostic work-up consisted of peripheral blood counts, bone marrow cytology, bone radiograms, serum biochemistry and cytogenetics. The International Staging System (ISS) was used. In every patient, at least 40 digital nuclear images from diagnostic May-Grünwald-Giemsa stained bone marrow smears were acquired and transformed into pseudo-3D images. FD was determined by the Minkowski-Bouligand method extended to three dimensions. Goodness-of-fit of FD was estimated by the R(2) values in the log-log plots. The influence of diagnostic features on overall survival was analyzed in Cox regressions. Patients that underwent autologous bone marrow transplantation were censored at the day of transplantation.Median age was 56 years. According to ISS, 14% of the patients were stage I, 39% were stage II and 47% were stage III. Additional features of a bad prognosis were observed in 46% of the cases. When stratifying for ISS, both FD and its goodness-of-fit were significant prognostic factors in univariate analyses. Patients with higher FD values or lower goodness-of-fit showed a worse outcome. In the multivariate Cox-regression, FD, R(2), and ISS stage entered the final model, which showed to be stable in a bootstrap resampling study.Fractal characteristics of the chromatin texture in routine cytological preparations revealed relevant prognostic information in patients with multiple myeloma

Acute leukemias in Piauí: comparison with features observed in other regions of Brazil

Differences in age and sex distribution as well as FAB (French-American-British classification) types have been reported for acute leukemias in several countries. We studied the demographics and response to treatment of patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) between 1989 and 2000 in Teresina, Piauí, and compared these results with reports from Brazil and other countries. Complete data concerning 345 patients (230 ALL, 115 AML) were reviewed. AML occurred predominantly in adults (77%), with a median age of 34 years, similar to that found in the southeast of Brazil but lower than the median age in the United States and Europe (52 years). FAB distribution was similar in children and adults and FAB-M2 was the most common type, as also found in Japan. The high frequency of FAB-M3 described in most Brazilian studies and for Hispanics in the United States was not observed. Overall survival for adults was 40%, similar to other studies in Brazil. A high mortality rate was observed during induction. No clinical or hematological parameter influenced survival in the Cox model. ALL presented the characteristic peak of incidence between 2-8 years. Most of the cases were CD10+ pre-B ALL. In 25%, abnormal expression of myeloid antigens was observed. Only 10% of the patients were older than 30 years. Overall survival was better for children. Age and leukocyte count were independent prognostic factors. These data demonstrate that, although there are regional peculiarities, the application of standardized treatments and good supportive care make it possible to achieve results observed in other countries for the same chemotherapy protocols.33133

The utility of fluorescence lifetime imaging in routine bone marrow

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Fractal dimension of chromatin is an independent prognostic factor for survival in melanoma

<p>Abstract</p> <p>Background</p> <p>Prognostic factors in malignant melanoma are currently based on clinical data and morphologic examination. Other prognostic features, however, which are not yet used in daily practice, might add important information and thus improve prognosis, treatment, and survival. Therefore a search for new markers is desirable. Previous studies have demonstrated that fractal characteristics of nuclear chromatin are of prognostic importance in neoplasias. We have therefore investigated whether the fractal dimension of nuclear chromatin measured in routine histological preparations of malignant melanomas could be a prognostic factor for survival.</p> <p>Methods</p> <p>We examined 71 primary superficial spreading cutaneous melanoma specimens (thickness ≥ 1 mm) from patients with a minimum follow up of 5 years. Nuclear area, form factor and fractal dimension of chromatin texture were obtained from digitalized images of hematoxylin-eosin stained tissue micro array sections. Clark's level, tumor thickness and mitotic rate were also determined.</p> <p>Results</p> <p>The median follow-up was 104 months. Tumor thickness, Clark's level, mitotic rate, nuclear area and fractal dimension were significant risk factors in univariate Cox regressions. In the multivariate Cox regression, stratified for the presence or absence of metastases at diagnosis, only the Clark level and fractal dimension of the nuclear chromatin were included as independent prognostic factors in the final regression model.</p> <p>Conclusion</p> <p>In general, a more aggressive behaviour is usually found in genetically unstable neoplasias with a higher number of genetic or epigenetic changes, which on the other hand, provoke a more complex chromatin rearrangement. The increased nuclear fractal dimension found in the more aggressive melanomas is the mathematical equivalent of a higher complexity of the chromatin architecture. So, there is strong evidence that the fractal dimension of the nuclear chromatin texture is a new and promising variable in prognostic models of malignant melanomas.</p