Influence of Zinc Deficiency and Severe Mucositis in Patients Undergoing Hematopoietic Stem Cell Transplatation

Hosp Israelita Albert Einstein, Oncol Hematol, Sao Paulo, BrazilHosp Israelita Albert Einstein, Dept Hematol & Oncol, Sao Paulo, BrazilHosp Israelita Albert Einstein, BMT, Sao Paulo, BrazilUniv Fed Sao Paulo, Endocrinol, Sao Paulo, BrazilUniv Fed Sao Paulo, Endocrinol, Sao Paulo, BrazilWeb of Scienc

Patients' Perceptions About Diagnosis And Treatment Of Chronic Myeloid Leukemia: A Cross-sectional Study Among Brazilian Patients.

Chronic myeloid leukemia (CML) requires strict daily compliance with oral medication and regular blood and bone marrow control tests. The objective was to evaluate CML patients' perceptions about the disease, their access to information regarding the diagnosis, monitoring and treatment, adverse effects and associations of these variables with patients' demographics, region and healthcare access. Prospective cross-sectional study among CML patients registered with the Brazilian Lymphoma and Leukemia Association (ABRALE). CML patients receiving treatment through the public healthcare system were interviewed by telephone. Among 1,102 patients interviewed, the symptoms most frequently leading them to seek medical care were weakness or fatigue. One third were diagnosed by means of routine tests. The time that elapsed between first symptoms and seeking medical care was 42.28 ± 154.21 days. Most patients had been tested at least once for Philadelphia chromosome, but 43.2% did not know the results. 64.8% had had polymerase chain reaction testing for the BCR/ABL gene every three months. 47% believed that CML could be controlled, but 33.1% believed that there was no treatment. About 24% reported occasionally stopping their medication. Imatinib was associated with nausea, cramps and muscle pain. Self-reported treatment adherence was significantly associated with normalized blood count, and positively associated with imatinib. There is a lack of information or understanding about disease monitoring tools among Brazilian CML patients; they are diagnosed quickly and have good access to treatment. Correct comprehension of CML control tools is impaired in Brazilian patients.0

Elderly Patients Undergone Hematopoietic Stem Cell Transplantation: Body Composition and Engraftment

Univ Fed Sao Paulo, Endocrinol, Sao Paulo, BrazilHosp Israelita Albert Einstein, Oncol & Hematol, Sao Paulo, BrazilHosp Israelita Albert Einstein, Sao Paulo, BrazilHosp Israelita Albert Einstein, Dept Hematol & Oncol, Sao Paulo, BrazilHosp Israelita Albert Einstein, BMT, Sao Paulo, BrazilUniv Fed Sao Paulo, Endocrinol, Sao Paulo, BrazilWeb of Scienc

Hematopoietic stem cells transplantation and acute myeloid leukemia: Brazilian guidelines

The objective of this work was to define guidelines for the indication of hematopoietic stem cells transplantation (HSCT) in the treatment of acute myeloid leukemia (AML) in Brazil. The role of HSCT in the treatment of AML was discussed by the authors and presented to the Brazilian Society of Bone Marrow Transplantation in a meeting to formulate and ratify the Brazilian Guidelines on HSCT. This consensus was based on a review of international publications and on the Brazilian experience in HSCT for the treatment of AML. The optimal treatment for AML in first complete remission (1CR) has not been defined yet. There is consensus on the indication of allogeneic HSCT with myeloablative conditioning for patients who present high risk cytogenetic changes. Allogeneic HSCT is not indicated for low cytogenetic risk 1RC patients and, apparently, allogeneic and autologous HSCT and consolidation chemotherapy are similar for intermediate risk patients.O objetivo deste trabalho foi definir diretrizes para a indicação do transplante de células-tronco hematopoéticas (TCTH) no tratamento da leucemia mieloide aguda (LMA) no Brasil. O papel do TCTH no tratamento da LMA foi discutido pelosautores e apresentado para a Sociedade Brasileira de Transplante de Medula Óssea na reunião sobre Diretrizes Brasileiras para o TCTH, que o ratificou. Este consenso foi baseado na revisão da literatura internacional e na experiência brasileira em TCTH para o tratamento da LMA. O tratamento ideal para leucemia mieloide aguda em primeira remissão completa (1RC) ainda não está definido. Há consenso na indicação do TCTH alogênico, com condicionamento mieloablativo, para pacientes que apresentem alterações citogenéticas consideradas de alto risco. O TCTH alogênico não está indicado na 1RC para pacientes de baixo risco citogenético e, aparentemente, o TCTH alogênico, autólogo ou a quimioterapia de consolidação são equivalentes para os pacientes de risco intermediário.Hospital de Clínicas de Porto Alegre Serviço de Hematologia e Transplante de Medula ÓsseaUniversidade de São Paulo Hospital das Clínicas Centro de Transplante de Medula ÓsseaHospital de Câncer de Barret HemonúcleoUniversidade Federal de São Paulo (UNIFESP) Hospital Israelita Albert Einstein Centro de Transplante de Medula ÓsseaAssociação de Combate ao Câncer em Goiás Hospital Araújo Jorge Serviço de Transplante de Medula ÓsseaHospital Israelita Albert Einstein Programa de Hematologia e Transplante de Medula ÓsseaUNIFESP, Hospital Israelita Albert Einstein Centro de Transplante de Medula ÓsseaSciEL

T-Cell-Replete Haploidentical Stem Cell Transplantation with Post-Transplant Cyclophosphamide for Patients with X-Linked Adrenoleukodystrophy: An Immediate Choice for an Urgent Situation

Inst Crianca HC FMUSP, Oncohematol Unit, Sao Paulo, BrazilHosp Israelita Albert Einstein, Sao Paulo, BrazilUniv Fed Parana, BR-80060000 Curitiba, Parana, BrazilUNIFESP Univ Fed Sao Paulo, Hematol & Bone Marrow Transplantat Dept, Sao Paulo, BrazilHosp Israelita Albert Einstein, Hematol & Bone Marrow Transplantat Dept, Sao Paulo, BrazilHosp Israelita Albert Einstein, Dept Bone Marrow Transplantat, Sao Paulo, BrazilHosp Clin FMUSP, Sao Paulo, BrazilUNIFESP Univ Fed Sao Paulo, Hematol & Bone Marrow Transplantat Dept, Sao Paulo, BrazilWeb of Scienc

Iron overload in a teenager with xerocytosis: the importance of nuclear magnetic resonance imaging

To report a case of iron overload secondary to xerocytosis, a rare disease in a teenager, diagnosed, by T2* magnetic resonance imaging. We report the case of a symptomatic patient with xerocytosis, a ferritin level of 350ng/mL and a significant cardiac iron overload. She was diagnosed by T2* magnetic resonance imaging and received chelation therapy Ektacytometric analysis confirmed the diagnosis of hereditary xerocytosis. Subsequent T2* magnetic resonance imaging demonstrated complete resolution of the iron overload in various organs, as a new echocardiography revealed a complete resolution of previous cardiac alterations. The patient remains in chelation therapy. Xerocytosis is a rare autosomal dominant genetic disorder characterized by dehydrated stomatocytosis. The patient may present with intense fatigue and iron overload. We suggest the regular use of T2* magnetic resonance imaging for the diagnosis and control of the response to iron chelation in xerocytosis, and we believe it can be used also in other hemolytic anemia requiring transfusions.Relatar um caso de sobrecarga de ferro secundária à xerocitose, uma doença rara, em uma adolescente, diagnosticada por meio de ressonância magnética em T2*. Relatamos o caso de uma paciente sintomática com xerocitose, nível de ferritina de 350ng/mL e sobrecarga de ferro cardíaca significativa. Ela foi diagnosticada por ressonância magnética em T2* e recebeu terapia de quelação. Análise por ectacitometria confirmou o diagnóstico de xerocitose hereditária. Na sequência, a ressonância magnética em T2* demonstrou resolução completa da sobrecarga de ferro em vários órgãos e novo ecocardiograma revelou resolução completa das alterações cardíacas anteriores. A paciente permanece em terapia de quelação. Xerocitose é uma desordem genética autossômica dominante rara, caracterizada por estomatocitose desidratada. O paciente pode apresentar fadiga intensa e sobrecarga de ferro. Sugerimos o uso regular de ressonância magnética em T2* para o diagnóstico e controle da resposta à quelação de ferro em xerocitose e acreditamos que o exame pode ser útil também em outras anemias hemolíticas que necessitam de transfusões.52853