Introduction: Treatment of childhood acute lymphoblastic leukemia (ALL) is based on risk stratification. This study aimed to assess the agreement between risk group classifications in the different childhood ALL treatment protocols used in a referral hospital in southern Brazil.
Methods:We retrospectively reviewed the medical records of patients aged 1 to 18 years with B-cell ALL treated at a hospital from January 2013 to April 2017. Agreement between risk classifications was assessed by the kappa coefficient.Results: Seventy-five patients were analyzed. There was poor agreement between risk stratification by GBTLI 2009 and BFM 95 protocols (kappa = 0.22; p = 0.003) and by GBTLI 2009 and IC-BFM 2002 protocols (kappa = 0.24; p = 0.002). Risk group distribution was 13.3% for low risk, 32.0% for intermediate risk, and 54.7% for high risk based on stratification by the GBTLI 2009 protocol, and 28.0% for low risk, 42.7% for intermediate risk, and 29.3% for high risk based on stratification by the IC-BFM 2002 protocol. Overall survival was 68.6%.
Conclusion:This study provides numerous points to ponder about the treatment of leukemia in Brazil. The percentage of patients classified as high risk in our sample was higher than that reported in the international literature. This difference, however, had no impact on overall survival, which was shorter than that reported in the international literature.
Different intrauterine exposures are associated with different metabolic profiles
leading to growth and development characteristics in children and also relate to
health and disease patterns in adult life. The objective of this work was to
evaluate the impact of four different intrauterine environments on the telomere
length of newborns. This is a longitudinal observational study using a
convenience sample of 222 mothers and their term newborns (>37 weeks of
gestational age) from hospitals in Porto Alegre, Rio Grande do Sul (Brazil),
from September 2011 to January 2016. Sample was divided into four groups:
pregnant women with Gestational Diabetes Mellitus (DM) (n=38), smoking pregnant
women (TOBACCO) (n=52), mothers with small-for-gestational age (SGA) children
due to idiopathic intrauterine growth restriction (n=33), and a control group
(n=99). Maternal and newborn genomic DNA were obtained from epithelial mucosal
cells. Telomere length was assessed by qPCR, with the calculation of the
telomere and single copy gene (T/S ratio). In this sample, there was no
significant difference in telomere length between groups (p>0.05). There was
also no association between childbirth weight and telomere length in children
(p>0.05). For term newborns different intrauterine environments seems not to
influence telomere length at birth.
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