Aspectos epidemiológicos, biotipologia e evolução do tratamento da leucemia linfocítica aguda na infância e adolescência no Rio Grande do Sul

Pereira, Waldir Veiga

doi:10.11606/t.5.2010.tde-22092010-144728

Cited by 4 publications

(9 citation statements)

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“…Surprisingly, differences between the rich and poor geographic areas of the country are lower than 2% ( 34 ). It is noteworthy that the survival rates of children with ALL living in the Rio Grande do Sul State reached EFS 5y = 62.41 ± 2.43% when treated with the GBTLI ALL protocols, while patients not included in any study had EFS 5y = 49.47 ± 4.15% ( 37 ). Unfortunately, less than 1% of the estimated new ALL patients with <18 years are registered in the GBTLI.…”

Section: Discussionmentioning

confidence: 99%

Shorter Maintenance Therapy in Childhood Acute Lymphoblastic Leukemia: The Experience of the Prospective, Randomized Brazilian GBTLI ALL-93 Protocol

et al. 2016

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AimMaintenance therapy is an important phase of the childhood ALL treatment, requiring 2-year long therapy adherence of the patients and families. Weekly methotrexate with daily 6-mercaptopurine (6MP) constitutes the backbone of maintenance therapy. Reduction in the maintenance therapy could overweight problems related with poverty of children with ALL living in limited-income countries (LIC).ObjectiveTo compare, prospectively, the EFS rates of children with ALL treated according to two maintenance regimens: 18 vs. 24 months duration.Materials and methodsFrom October 1993 to September 1999, 867 consecutive untreated ALL patients <18 years of age were treated according to the Brazilian Cooperative Group for Childhood ALL Treatment (GBTLI) ALL-93 protocol. Risk classification was based exclusively on patient’s age and leukocyte count (NCI risk group) and clinical extra medullary involvement of the disease. Data were analyzed by the intention-to-treat approach.ResultsFourteen patients (1.6%) were excluded: wrong diagnosis (n = 7) and previous corticosteroid (n = 7). Of the 853 eligible patients, 421 were randomly allocated, at study enrollment, to receive 18-month (group 1) and 432 to receive 24-month (group 2) maintenance therapy. Complete remission rate was achieved in 96% of the patients (817/853). Twenty-eight patients (3.4%) died during the induction phase. Thirty-four patients (4.0%) were lost to follow-up. The overall EFS was 66.1 ± 1.7% at 15 years. No difference was seen according to maintenance: EFS15y was 65.8 ± 2.3% (group 1) and 66.3 ± 2.3% (group 2; p = 0.79). No difference between regimens was detected after stratifying the analyses according to factors associated with adverse prognosis in this study (age group <1 year or >10 years and high WBC at diagnosis). Overall death in remission rate was 6.85% (56 patients). Deaths during maintenance were 13 in group 1 and 12 in group 2, all due to infection. Over 15 years of follow-up, two patients both from group 2 presented a second malignancy (Hodgkin’s disease and thyroid carcinoma) after 8.3 and 11 years off therapy, respectively.ConclusionSix-month reduction of maintenance therapy in ALL children treated according to the GBTLI ALL-93 protocol provided the same overall outcome as 2-year duration regimen.

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Section: Discussionmentioning

confidence: 99%

Shorter Maintenance Therapy in Childhood Acute Lymphoblastic Leukemia: The Experience of the Prospective, Randomized Brazilian GBTLI ALL-93 Protocol

et al. 2016

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“…Os fármacos utilizados nessa etapa são os corticosteroides, principalmente prednisona e dexametasona. A Asparaginase diminui a asparagina extracelular que é essencial para a sobrevivência das células, particularmente de algumas células malignas que não conseguem sintetizá-la (PEREIRA, 2010;LUHANA;DAVE;PATEL, 2013;LOPES et al, 2017). A ação da daunorrubicina está ligada à inibição da síntese de DNA e RNA.…”

Section: Resultados E Discussõesunclassified

“…A ação da daunorrubicina está ligada à inibição da síntese de DNA e RNA. É mais ativa na fase S da divisão celular (PEREIRA, 2010;CARTA;FERLIN, 2014;YEO et al, 2016).…”

Section: Resultados E Discussõesunclassified

“…O filgrastim é indicado para redução da duração da neutropenia febril em pacientes tratados com quimioterapia citotóxica (CHABNER; LONGO, 2015). A dexametasona é destinada ao tratamento de condições nas quais os efeitos antiinflamatórios e imunossupressores dos corticosteroides são desejados, especialmente para tratamento intensivo durante períodos mais curtos como a púrpura trombocitopênica idiopática, trombocitopenia secundária, anemia hemolítica adquirida, eritroblastopenia, anemia hipoplástica congênita e no tratamento paliativo de leucemias e linfomas (PEREIRA, 2010).…”

Section: Resultados E Discussõesunclassified

“…O ácido fólico age como um suplemento contra anemia para suprir as necessidades em pacientes como gestantes ou pacientes com anemias causadas pela carência dessas substâncias. É importante no desenvolvimento do sistema nervoso fetal (PEREIRA, 2010;IRVING, 2015). A vincristina bloqueia a divisão celular (bloqueia a mitose), agindo especificamente na fase M da divisão celular.…”

Section: Resultados E Discussõesunclassified

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Leucemia linfocítica aguda: Relato de caso / Acute lymphocytic leukemia: Case report

Lehnen¹,

Jardim²,

Saposki³

et al. 2021

BJDV

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A Leucemia é uma doença maligna com o acúmulo de células jovens na medula óssea que substituem as células sanguíneas normais. Embora a doença seja mais comum em crianças, pessoas de ambos os gêneros e de todas as faixas etárias são acometidos. O tratamento é realizado com medicamentos quimioterápicos e transplante de medula óssea. Todos os protocolos de tratamento causam efeitos adversos e problemas na qualidade de vida dos pacientes. O objetivo dessa pesquisa foi relatar o diagnóstico seguido da evolução do quadro clínico de uma paciente voluntária que fez tratamento através da quimioterapia. A metodologia foi através da análise documental do prontuário e os resultados foram expressos em tabelas comparando a evolução do quadro clínico pelos laudos de hemogramas com tratamento. No início, o diagnóstico foi confundido com anemia megaloblástica e após, a paciente foi encaminhada ao hematologista que solicitou exames para diagnóstico diferencial. O mielograma e imunofenotipagem comprovaram a Leucemia Linfocítica Aguda do tipo B. No mês de junho de 2017 a paciente iniciou as fases do tratamento que são divididas em indução, remissão e manutenção. O Protocolo utilizado foi HiperC-VAD (ciclofosfamida, vincristina, doxorrubicina, dexametasona, alternando com citarabina e metotrexato). A paciente esteve em tratamento no CEPON de Florianópolis com resposta positiva até o período de junho de 2018. No momento, está em fase de manutenção com terapia mais branda. O tratamento dura cerca de dois anos e meio para mulheres. O prognóstico e sucesso na cura da doença estão relacionados com a idade, principalmente com a imunofenotipagem, adesão ao tratamento e com alteração citogenética da LLA. A terapia pode ser agressiva e trazer severos efeitos adversos, por isso, torna-se necessária cautela na escolha da terapia.

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A Experiência Do Depoimento Especial a Partir Da Perspectiva De Meninas Adolescentes Vítimas De Abuso Sexual

Ramos,

Antoni

2023

Psicodebate

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Public policies have been developed to assist children and adolescents who are witnesses or victims of different types of abuse. Among them, the Protected Listening Law implemented in Brazil the special testimony (ST), which is a welcoming way of listening to victims in hearing and which aims to protect against re-victimization. This exploratory-descriptive qualitative research aimed to understand how adolescent girls who were victims of sexual abuse, who went through mental health care understood their experience of being heard by the ST. Seven adolescent girls aged 12 to 17 years participated in the study. Interviews and information from medical records were used for data collection. A thematic analysis of the findings was carried out and two themes were obtained: experience with the ST and #takethetip. The appreciation of the data identified that the girls had negative expectations about the ST and felt anxiety, fear and sadness before it occurred. After the beginning of the hearing, they became calmer and at the end, they felt relieved. Despite the discomfort of speaking, they understand that it is important, including encouraging other adolescents to participate in the ST. Finally, they indicate that it is not necessary to change how the ST is organized. It is understood, therefore, that the assistance of specialized technicians and the organization of the courtroom are related to the process of relieving the anxiety of the participants throughout the ST, since it is not necessary to change the way the ST is organized.

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Aspectos epidemiológicos, biotipologia e evolução do tratamento da leucemia linfocítica aguda na infância e adolescência no Rio Grande do Sul

Cited by 4 publications

References 53 publications

Shorter Maintenance Therapy in Childhood Acute Lymphoblastic Leukemia: The Experience of the Prospective, Randomized Brazilian GBTLI ALL-93 Protocol

Shorter Maintenance Therapy in Childhood Acute Lymphoblastic Leukemia: The Experience of the Prospective, Randomized Brazilian GBTLI ALL-93 Protocol

Leucemia linfocítica aguda: Relato de caso / Acute lymphocytic leukemia: Case report

A Experiência Do Depoimento Especial a Partir Da Perspectiva De Meninas Adolescentes Vítimas De Abuso Sexual

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