This population-based study was designed to detect the prevalence of anemia in a healthy population of children (18 months to 7 years) and women (14 to 30 years) tested in 2006–2007 in the state of Rio Grande do Sul, Brazil as part of an effort to tackle this massive problem that still affects so many people in the XXI century. Anemia was defined according to the WHO. Capillary blood was measured and socioeconomic status was determined according to the Brazilian Association of Market Research Agencies. The median prevalence of anemia in 2198 children was 45.4% and in 1999 women 36.4%. Anemia decreased with age during childhood; although significantly more prevalent in lower classes individuals, it was also high in the upper classes. There are indirect evidences that the lack of iron supplementation and/or iron fortified food may play a role in it. Professionals and society wise measures of education have to be implemented in order to address possible biologic factors involved in childhood psychosocial development in southern Brazil.

Key Points• High DNp73/TAp73 expression ratio is associated with lower overall survival and higher cumulative incidence of relapse in APL.• DNp73/TAp73 expression ratio is an independent prognostic marker in APL.The TP73 gene transcript is alternatively spliced and translated into the transcriptionally active (TAp73) or inactive (DNp73) isoforms, with opposite effects on the expression of p53 target genes and on apoptosis induction. The imbalance between DNp73 and TAp73 may contribute to tumorigenesis and resistance to chemotherapy in human cancers, including hematologic malignancies. In acute promyelocytic leukemia (APL), both isoforms are expressed, but their relevance in determining response to therapy and contribution to leukemogenesis remains unknown. Here, we provide the first evidence that a higher DNp73/ TAp73 RNA expression ratio is associated with lower survival, lower disease-free survival, and higher risk of relapse in patients with APL homogeneously treated with all-trans retinoic acid and anthracycline-based chemotherapy, according to the International Consortium on Acute Promyelocytic Leukemia (IC-APL) study. Cox proportional hazards modeling showed that a high DNp73/TAp73 ratio was independently associated with shorter overall survival (hazard ratio, 4.47; 95% confidence interval, 1.64-12.2; P 5 .0035). Our data support the hypothesis that the DNp73/TAp73 ratio is an important determinant of clinical response in APL and may offer a therapeutic target for enhancing chemosensitivity in blast cells. (Blood. 2015;126(20):2302-2306

CML is a well characterized disease with a known chromosomal abnormality. The inhibition of BCR-ABL protein tyrose kinase activity represented an advance in the treatment of this disease. Imatinib is effective in chronic, accelerated and blastic phase disease, and is the CML first line treatment around the world. In Brazil, this drug is provided by the State since 2003. The drug is available for second line treatment in chronic phase and for accelerated and blastic phase as the first line therapy. In chronic phase, the patients are treated first with interferon. If this treatment is too toxic or not effective, the choice therapy is imatinib 400 mg and the dose can be escalated up 600 mg. In accelerated and blastic phases the treatment is imatinib 600 mg. Mutational studies are not routinely performed and the failing patients are encourage to participate in bone marrow transplantation programs or clinical research centers. The present data are obtained from public health hospital database and included 400 CML Ph+ patients from Rio Grande do Sul, south of Brazil. 232 patients are male and 158 female and around 70% were Caucasian. The median age at diagnosis was 46, 79 y (median 49, 28). The mean laboratory values at diagnosis were: hematocrit 33 (median 34, 8), hemoglobin 11, 08 (median 11, 40), white blood cells 158.594 (median 110.000) and platelets 466.000 (median 380.000). From the 400 patients, 300 pts were diagnosed in chronic phase, 52 pts in accelerated phase and 20 pts in blastic phase. In 28 patients the disease phase was unknown. In the majority of patients Imatinib was started because interferon treatment was not tolerated (121 patients) or ineffective (123 patients). Of these patients 285 were in chronic, 59 pts in accelerated and 17 pts in blastic phases. The cytogenetic response evaluated at 12 months of treatment was available in 231 patients: 164 complete responses, 20 major responses, 15 minor responses and 32 patients demonstrated none or minimal response to therapy. In 169 patients the response is unknown. The progression free survival for the chronic phase patients in 80 months of observation is 90% and the event free survival for the entire group is 60% in the same period. The progression from chronic to accelerated or blastic phase was more common in the first year of imatinib treatment and decreased progressively until the fifth year of therapy. This data demonstrate the epidemiologic profile and the treatment results of CML patients in south of Brazil. Imatinib is available in public health system as a second line treatment and the survival rate is quite good. Since last July this drug has been available as first line treatment, even in chronic phase. A longer follow up and a uniform database registry are needed to study the impact of imatinib treatment in this population.

We ran a study on the prevalence of anemia in the state of Rio Grande do Sul (RS), southern Brazil. RS is in a sub-tropical Latin American area, near Uruguay and Argentina. There is no Malaria, a low prevalence of hemoglobinopaties, and HIV/AIDS. METHODS: Capillary blood of children less then 7 and women from 14 to 30 years of age were tested. Socioeconomic status was determined utilizing the classification designed by the Brazilian Association of Market Research Agencies for this purpose. A second sample of 1 year old children was submitted to total blood cell count and serum ferritin determination, and in a third group of individuals, total blood count was done along with stool parasitic analysis. RESULTS: A total of 2198 children and 1999 women with capillary blood measured were analyzed. The median prevalence of anemia in the whole state and the median hemoglobin concentration was 45, 4% and 9.90g/dl for children, and 36.1% and 11 g/dl for women, respectively. Of the aforementioned group, before two years of age, 76% were anemic, and anemia prevalence decreased with age, suggesting a nutrition deficiency. There were very few cases of severe anemia. A significant percentage of children and women belong to the middle class, with access to food and medical care. Of the 356 children tested at one year of age, 67% were anemic and of these, 90% had ferritin < 15μg/L. In the third group of individuals, 31% of 424 children less then 6 years of age were anemic and of these, only 13% tested positive for parasitic infection. CONCLUSION: The prevalence of iron deficiency anemia is very high and constitutes a severe public health problem for 1 year old children in RS, and probably for those younger then 7, and for fertile women as well, irrespectively of their socioeconomic level. Micronutrients supplementation has being neglected in RS health system. The definition of anemia plays a central role in this and has to be addressed if we want to overcome the biologic factors involved in childhood psychosocial development in Brazil.