Ciliana Rechenmacher - Academia.edu (original) (raw)
Papers by Ciliana Rechenmacher
Genetics and Molecular Biology, Mar 2, 2017
Urease catalyzes the hydrolysis of urea to ammonia and carbon dioxide. The ammonia (nitrogen (N) ... more Urease catalyzes the hydrolysis of urea to ammonia and carbon dioxide. The ammonia (nitrogen (N) product of urease activity) is incorporated into organic compounds. Thus, urease is involved in N remobilization, as well as in primary N assimilation. Two urease isoforms have been described for soybean: the embryo-specific, encoded by the Eu1 gene, and the ubiquitous urease, encoded by Eu4. A third urease-encoding gene was recently identified, designated Eu5, which encodes the putative protein product SBU-III. The present study aimed to evaluate the contribution of soybean ureases to seed germination and plant development. Analyses were performed using Eu1/Eu4/Eu5co-suppressed transgenic plants and mutants of the Eu1 and Eu4 urease structural genes, as well as a urease-null mutant (eu3-a) that activates neither the ubiquitous nor embryo-specific ureases. The co-suppressed plants presented a developmental delay during the first month after germination; shoots and roots were significantly smaller and lighter. Slower development was observed for the double eu1-a/eu4-a mutant and the eu3-a single mutant. The N content in transgenic plants was significantly lower than in non-transgenic plants. Among the mutants, eu3-a presented the lowest and eu1-a the highest N content. Altogether, these results indicate that increased ureolytic activity plays an important role in plant development.
Ó The Author(s) 2012. This article is published with open access at Springerlink.com Abstract The... more Ó The Author(s) 2012. This article is published with open access at Springerlink.com Abstract The soybean ubiquitous urease (encoded by GmEu4) is responsible for recycling metabolically derived urea. Additional biological roles have been demonstrated for plant ureases, notably in toxicity to other organisms. However, urease enzymatic activity is not related to its toxicity. The role of GmEu4 in soybean susceptibility to fungi was investigated in this study. A differential expression pattern of GmEu4 was observed in susceptible and resistant genotypes of soybeans over the course of a Phakopsora pachyrhizi infection, especially 24 h after Electronic supplementary material The online version of this article (doi:10.1007/s11103-012-9894-1) contains supplementary material, which is available to authorized users. B. Wiebke-Strohm M. Margis-Pinheiro M. Bencke
Blechnum tabulare (Thunb.) Kuhn is a subarborescent fern widely distributed in the “Campos de Cim... more Blechnum tabulare (Thunb.) Kuhn is a subarborescent fern widely distributed in the “Campos de Cima da Serra” region in State of Rio Grande do Sul, Brazil. This study describes the structure and spatial patterns of a B. tabulare population in the municipality of Sao Francisco de Paula. All young and adult individuals in a total of 60 contiguous 25 m 2 grassland quadrats were sampled and the estimated size recorded for height-frequency distribution analysis. The spatial position of each quadrat was defined by X and Y coordinates and the spatial distribution of the plants plotted by a distance clustering index. A total of 367 individuals were sampled, of which 144 were young (non-fertile) and 223 adult individuals (fertile), which were distributed in four height classes. The higher frequency of juveniles indicated great potential of population recruitment across the area. The young individuals (Ia = 1.41; P = 0.03) were more grouped than adults (Ia = 0.94; P = 0.54), probably due to mo...
Genetics and Molecular Biology
Different intrauterine exposures are associated with different metabolic profiles leading to grow... more 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.
Fern distribution patterns are related to biotic and abiotic factors. We evaluated the spatial di... more Fern distribution patterns are related to biotic and abiotic factors. We evaluated the spatial distribution pattern of the fern species occurring at Parque Natural Municipal da Ronda, in Sao Francisco de Paula, Rio Grande do Sul, Brazil; and characterized the population structure of Dicksonia sellowiana Hook., the only tree fern species recorded at the sampling. We counted all present individuals in 40 randomly installed, 25m2 plots, in a hectare of mixed humid forest and in a hectare of secondary forest, in order to determine spatial distribution patterns, using Morisita’s Index and Variance/Mean Ratio. We recorded 524 plants at the secondary forest and 503 at the mixed humid forest, distributed in eight fern species, at both sites. The aggregated spatial distribution observed for all analyzed species is a tendency found by other authors for other ferns. Dicksonia sellowiana presented a significantly higher frequency of individuals at the class of lower height, indicating a great p...
Osmotins are multifunctional proteins belonging to the thaumatin-like family related to plant str... more Osmotins are multifunctional proteins belonging to the thaumatin-like family related to plant stress responses. To better understand the functions of soybean osmotins in drought stress response, the current study presents the characterisation of four previously described proteins and a novel putative soybean osmotin (GmOLPa-like). Gene and protein structure as well as gene expression analyses were conducted on different tissues and developmental stages of two soybean cultivars with varying dehydration sensitivities (BR16 and EMB48 are highly and slightly sensitive, respectively). The analysed osmotin sequences share the conserved amino acid signature and 3D structure of the thaumatin-like family. Some differences were observed in the conserved regions of protein sequences and in the electrostatic surface potential. P21-like present the most similar electrostatic potential to osmotins previously characterised as promoters of drought tolerance in Nicotiana tabacum and Solanum nigrum. ...
Biotechnology Research and Innovation
Clinical & Biomedical Research
Pediatric Blood & Cancer
Strategies to mitigate the impact of COVID‐19 in special populations are complex and challenging.... more Strategies to mitigate the impact of COVID‐19 in special populations are complex and challenging. Few studies have addressed the impact of COVID‐19 on pediatric patients with cancer in low‐ and middle‐income countries.
Brazil is the largest country in South America with continental dimensions and significant region... more Brazil is the largest country in South America with continental dimensions and significant regional differences. Recently, the country has faced a great challenge in establishing adequate strategies to mitigate the strong impact caused by the arrival of COVID-19 in the national territory. Since the first case diagnosed on February 26th, 2020, we have gone through a 18 week period that resulted in 58.300 deaths and more than 1.370.000 confirmed cases¹. Despite having a public and universal health system, most pediatric oncology centers are located in more urbanized regions, such as state capitals or economic centers. Few reports describe the impact of SARS-CoV-2 on the population of pediatric patients accompanied by cancer or undergoing hematopoietic stem cell transplantation (HSCT)2,3,4. Less frequent still are the descriptions of the situation of these children in low or middle income countries⁵. Faced with this new and unknown scenario, the present study aims to describe the clinical presentation and the evolution of children affected by COVID-19 undergoing treatment in units of oncology, hematology or HSCT. We are analyzing the interregional differences in the presentation, management and prognosis of these children, while drawing a national panorama that can be compared with other countries through a national and multicenter registry of children evaluated for SARS-CoV-2.Through dissemination by the Brazilian Society of Pediatric Oncology (SOBOPE), Brazilian Association of Hematology and Hemotherapy (ABHH) and Brazilian Society of Bone Marrow Transplantation (SBTMO). 36 centers across the country agreed to participate in this project (Figure 1). All regions of the country are included. The variables evaluated are clinical symptoms, diagnostic method, therapeutic measures and treatment location. In addition, the repercussions of infection on baseline treatment and overall prognosis are being assessed. Despite being in an initial phase, the database already counts with 64 registered cases.This joint work of the centers for pediatric oncology and bone marrow transplantation in our country is an advance that is allowing the development of one of the largest databases on the influence of COVID19 in the treatment of children in developing countries. Considering the small number of current literature on this subject, the heterogeneity of our population and regional differences, centralization of records is essential to better understand the extent and impact of this epidemic in our country, in addition to comparing the effect of local health strategies. It is important to highlight that the Sistema Unico de Saude (SUS), one of the largest and most complex public health systems in the world, guarantees universal health care and presents itself as a significant differential in combating the pandemic in Brazil through primary care, as well as medium and high complexity assistance.The development of this study will contribute to a better understanding of the clinical presentation, evolution and impact of that of COVID-19 in pediatric cancer patients or those undergoing HSCT in middle-income countries.
British Journal of Haematology
Our group recently showed that the (ASNase) formulation available in Brazil from 2017 to 2018 whe... more Our group recently showed that the (ASNase) formulation available in Brazil from 2017 to 2018 when used at the same dose and frequency as the formulation provided previously did not reach the activity considered therapeutic. Based on these, our goal was to assess the impact of these facts on the prognosis of children with ALL at different oncology centers. A multicentre retrospective observational study followed by a prospective follow‐up. Patients aged >1 and <18 years in first‐line treatment followed up at 10 referral centres, between 2014 and 2018 who received the formulation Leuginase® were identified (Group B). For each patient, the centre registered 2 patients who received ASNase in the presentation of Aginasa® exclusively (Group A). Data collection was registered using (Redcap®). A total of 419 patients were included; 282 in Group A and 137 in B. Group A had a 3‐year OS and EFS of 91·8% and 84·8% respectively, while Group B had a 3‐year OS of 83·8% (P = 0·003) and EFS of 76·1% (P = 0·008). There was an impact on 3‐year OS and EFS of children who received a formulation. This result highlights the importance of evaluating ASNase and monitoring its activity.
Scientific Reports
Acute lymphoid leukemia is a childhood cancer that in high-income countries has event-free surviv... more Acute lymphoid leukemia is a childhood cancer that in high-income countries has event-free survival rates of 80% and global survival rates of 90%. In Brazil these rates are under 70%. This difference may be due to the implementation of supportive care, including the assessment of asparaginase (ASNase) activity. ASNase may cause hypersensitivity reactions and silent drug inactivation. For this reason, ASNase activity monitoring is an essential tool to ensure an effective treatment. Our aim was to implement an ASNase activity measurement technique at a hospital setting. samples from children who were given Escherichia coli-derived ASNase were collected. The results of the analyses conducted in our laboratory Hospital de Clínicas de Porto Alegre were compared to those of two institutions: Centro Infantil Boldrini and University of Munster. 262 samples were assessed. The results of the first analyses were compared with those obtained at Centro Infantil Boldrini and showed an ICC of 0.95...
SSRN Electronic Journal
Background: Our research group recently showed that the only ASNase formulation available in Braz... more Background: Our research group recently showed that the only ASNase formulation available in Brazil from 2017 to 2018 when used at the same dose and frequency as the formulation provided previously did not reach, in most cases, the serum activity considered therapeutic. Based on these data, our goal was to assess the impact of these facts on the prognosis of children with ALL at 10 different pediatric oncology centers in our country. Methods: a multicenter retrospective observational study followed by prospective follow-up. Patients aged >1 and <18 years in first-line treatment followed up at 10 referral centers of Brazil, between 2014 and 2018 who received the formulation Leuginase® were identified (Group B). For each patient, the center registered 2 patients who received ASNase in the presentation of Aginasa® exclusively (Group A). Data collection was performed by searching for medical records and registered using Redcap® software. Findings: A total of 419 patients were included; 282 in Group A and 137 in Group B. Clinical features at diagnosis were similar in both groups. Group A had a 3-year OS and EFS of 91·8% and 84·8% respectively, while Group B had a 3-year OS of 83·8% (p= 0·003) and EFS of 76·1% (p = 0·008). Interpretation: There was an impact on 3-year OS and EFS of children who received an asparaginase formulation that previously showed inferior activity in laboratory analysis. This result highlights the importance of evaluating asparaginase formulations and monitoring their activity during treatment. Funding Statement: The research was supported by FIPE/HCPA (Fundo de Incentivo a Pesquisa e Eventos do Hospital de Clinicas de Porto Alegre). Declaration of Interests: The authors declare no conflicts of interest. Ethics Approval Statement: Ethical approval to conduct this study has been granted by the Ethics Committee of Hospital de Clinicas de Porto Alegre (HCPA). Participating adults as well as those responsible for minors signed informed consents in duplicate, keeping a copy for themselves.
Bone Marrow Transplantation
In the COVID-19 scenario, patients undergoing hematopoietic stem cell transplantation (HSCT) infe... more In the COVID-19 scenario, patients undergoing hematopoietic stem cell transplantation (HSCT) infected with SARS-CoV-2 may have an increased risk of death. Through a national multicenter study, we aimed to describe the impact of COVID-19 on the survival of HSCT recipients in Brazil. Eighty-six patients with a confirmed diagnosis of SARS-CoV-2 (92% by RT-PCR) were included. There were 24 children and 62 adults receiving an autologous (n = 25) and allogeneic (n = 61) HSCT for malignant (n = 72) and non-malignant (n = 14) disorders. Twenty-six patients died, (10 on autologous (38%) and 16 patients (62%) on allogeneic group). The estimated overall survival (OS) at day 40 was 69%. Adults had decreased OS compared to children (66% vs 79%, p = 0.03). The severity of symptoms at the time of diagnosis, ECOG score, laboratory tests (C-reactive protein, urea values) were higher in patients who died (p < 0.05). In conclusion, HSCT recipients infected with SARS-CoV-2 have a high mortality rate mainly in adults and patients with critical initial COVID-19 presentation. These findings show the fragility of HSCT recipients with SARS-CoV-2 infection. Therefore, the importance of adherence to preventive measures is evident, in addition to prioritizing the vaccination of family members and the HSCT team.
Genetics and Molecular Biology, Mar 2, 2017
Urease catalyzes the hydrolysis of urea to ammonia and carbon dioxide. The ammonia (nitrogen (N) ... more Urease catalyzes the hydrolysis of urea to ammonia and carbon dioxide. The ammonia (nitrogen (N) product of urease activity) is incorporated into organic compounds. Thus, urease is involved in N remobilization, as well as in primary N assimilation. Two urease isoforms have been described for soybean: the embryo-specific, encoded by the Eu1 gene, and the ubiquitous urease, encoded by Eu4. A third urease-encoding gene was recently identified, designated Eu5, which encodes the putative protein product SBU-III. The present study aimed to evaluate the contribution of soybean ureases to seed germination and plant development. Analyses were performed using Eu1/Eu4/Eu5co-suppressed transgenic plants and mutants of the Eu1 and Eu4 urease structural genes, as well as a urease-null mutant (eu3-a) that activates neither the ubiquitous nor embryo-specific ureases. The co-suppressed plants presented a developmental delay during the first month after germination; shoots and roots were significantly smaller and lighter. Slower development was observed for the double eu1-a/eu4-a mutant and the eu3-a single mutant. The N content in transgenic plants was significantly lower than in non-transgenic plants. Among the mutants, eu3-a presented the lowest and eu1-a the highest N content. Altogether, these results indicate that increased ureolytic activity plays an important role in plant development.
Ó The Author(s) 2012. This article is published with open access at Springerlink.com Abstract The... more Ó The Author(s) 2012. This article is published with open access at Springerlink.com Abstract The soybean ubiquitous urease (encoded by GmEu4) is responsible for recycling metabolically derived urea. Additional biological roles have been demonstrated for plant ureases, notably in toxicity to other organisms. However, urease enzymatic activity is not related to its toxicity. The role of GmEu4 in soybean susceptibility to fungi was investigated in this study. A differential expression pattern of GmEu4 was observed in susceptible and resistant genotypes of soybeans over the course of a Phakopsora pachyrhizi infection, especially 24 h after Electronic supplementary material The online version of this article (doi:10.1007/s11103-012-9894-1) contains supplementary material, which is available to authorized users. B. Wiebke-Strohm M. Margis-Pinheiro M. Bencke
Blechnum tabulare (Thunb.) Kuhn is a subarborescent fern widely distributed in the “Campos de Cim... more Blechnum tabulare (Thunb.) Kuhn is a subarborescent fern widely distributed in the “Campos de Cima da Serra” region in State of Rio Grande do Sul, Brazil. This study describes the structure and spatial patterns of a B. tabulare population in the municipality of Sao Francisco de Paula. All young and adult individuals in a total of 60 contiguous 25 m 2 grassland quadrats were sampled and the estimated size recorded for height-frequency distribution analysis. The spatial position of each quadrat was defined by X and Y coordinates and the spatial distribution of the plants plotted by a distance clustering index. A total of 367 individuals were sampled, of which 144 were young (non-fertile) and 223 adult individuals (fertile), which were distributed in four height classes. The higher frequency of juveniles indicated great potential of population recruitment across the area. The young individuals (Ia = 1.41; P = 0.03) were more grouped than adults (Ia = 0.94; P = 0.54), probably due to mo...
Genetics and Molecular Biology
Different intrauterine exposures are associated with different metabolic profiles leading to grow... more 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.
Fern distribution patterns are related to biotic and abiotic factors. We evaluated the spatial di... more Fern distribution patterns are related to biotic and abiotic factors. We evaluated the spatial distribution pattern of the fern species occurring at Parque Natural Municipal da Ronda, in Sao Francisco de Paula, Rio Grande do Sul, Brazil; and characterized the population structure of Dicksonia sellowiana Hook., the only tree fern species recorded at the sampling. We counted all present individuals in 40 randomly installed, 25m2 plots, in a hectare of mixed humid forest and in a hectare of secondary forest, in order to determine spatial distribution patterns, using Morisita’s Index and Variance/Mean Ratio. We recorded 524 plants at the secondary forest and 503 at the mixed humid forest, distributed in eight fern species, at both sites. The aggregated spatial distribution observed for all analyzed species is a tendency found by other authors for other ferns. Dicksonia sellowiana presented a significantly higher frequency of individuals at the class of lower height, indicating a great p...
Osmotins are multifunctional proteins belonging to the thaumatin-like family related to plant str... more Osmotins are multifunctional proteins belonging to the thaumatin-like family related to plant stress responses. To better understand the functions of soybean osmotins in drought stress response, the current study presents the characterisation of four previously described proteins and a novel putative soybean osmotin (GmOLPa-like). Gene and protein structure as well as gene expression analyses were conducted on different tissues and developmental stages of two soybean cultivars with varying dehydration sensitivities (BR16 and EMB48 are highly and slightly sensitive, respectively). The analysed osmotin sequences share the conserved amino acid signature and 3D structure of the thaumatin-like family. Some differences were observed in the conserved regions of protein sequences and in the electrostatic surface potential. P21-like present the most similar electrostatic potential to osmotins previously characterised as promoters of drought tolerance in Nicotiana tabacum and Solanum nigrum. ...
Biotechnology Research and Innovation
Clinical & Biomedical Research
Pediatric Blood & Cancer
Strategies to mitigate the impact of COVID‐19 in special populations are complex and challenging.... more Strategies to mitigate the impact of COVID‐19 in special populations are complex and challenging. Few studies have addressed the impact of COVID‐19 on pediatric patients with cancer in low‐ and middle‐income countries.
Brazil is the largest country in South America with continental dimensions and significant region... more Brazil is the largest country in South America with continental dimensions and significant regional differences. Recently, the country has faced a great challenge in establishing adequate strategies to mitigate the strong impact caused by the arrival of COVID-19 in the national territory. Since the first case diagnosed on February 26th, 2020, we have gone through a 18 week period that resulted in 58.300 deaths and more than 1.370.000 confirmed cases¹. Despite having a public and universal health system, most pediatric oncology centers are located in more urbanized regions, such as state capitals or economic centers. Few reports describe the impact of SARS-CoV-2 on the population of pediatric patients accompanied by cancer or undergoing hematopoietic stem cell transplantation (HSCT)2,3,4. Less frequent still are the descriptions of the situation of these children in low or middle income countries⁵. Faced with this new and unknown scenario, the present study aims to describe the clinical presentation and the evolution of children affected by COVID-19 undergoing treatment in units of oncology, hematology or HSCT. We are analyzing the interregional differences in the presentation, management and prognosis of these children, while drawing a national panorama that can be compared with other countries through a national and multicenter registry of children evaluated for SARS-CoV-2.Through dissemination by the Brazilian Society of Pediatric Oncology (SOBOPE), Brazilian Association of Hematology and Hemotherapy (ABHH) and Brazilian Society of Bone Marrow Transplantation (SBTMO). 36 centers across the country agreed to participate in this project (Figure 1). All regions of the country are included. The variables evaluated are clinical symptoms, diagnostic method, therapeutic measures and treatment location. In addition, the repercussions of infection on baseline treatment and overall prognosis are being assessed. Despite being in an initial phase, the database already counts with 64 registered cases.This joint work of the centers for pediatric oncology and bone marrow transplantation in our country is an advance that is allowing the development of one of the largest databases on the influence of COVID19 in the treatment of children in developing countries. Considering the small number of current literature on this subject, the heterogeneity of our population and regional differences, centralization of records is essential to better understand the extent and impact of this epidemic in our country, in addition to comparing the effect of local health strategies. It is important to highlight that the Sistema Unico de Saude (SUS), one of the largest and most complex public health systems in the world, guarantees universal health care and presents itself as a significant differential in combating the pandemic in Brazil through primary care, as well as medium and high complexity assistance.The development of this study will contribute to a better understanding of the clinical presentation, evolution and impact of that of COVID-19 in pediatric cancer patients or those undergoing HSCT in middle-income countries.
British Journal of Haematology
Our group recently showed that the (ASNase) formulation available in Brazil from 2017 to 2018 whe... more Our group recently showed that the (ASNase) formulation available in Brazil from 2017 to 2018 when used at the same dose and frequency as the formulation provided previously did not reach the activity considered therapeutic. Based on these, our goal was to assess the impact of these facts on the prognosis of children with ALL at different oncology centers. A multicentre retrospective observational study followed by a prospective follow‐up. Patients aged >1 and <18 years in first‐line treatment followed up at 10 referral centres, between 2014 and 2018 who received the formulation Leuginase® were identified (Group B). For each patient, the centre registered 2 patients who received ASNase in the presentation of Aginasa® exclusively (Group A). Data collection was registered using (Redcap®). A total of 419 patients were included; 282 in Group A and 137 in B. Group A had a 3‐year OS and EFS of 91·8% and 84·8% respectively, while Group B had a 3‐year OS of 83·8% (P = 0·003) and EFS of 76·1% (P = 0·008). There was an impact on 3‐year OS and EFS of children who received a formulation. This result highlights the importance of evaluating ASNase and monitoring its activity.
Scientific Reports
Acute lymphoid leukemia is a childhood cancer that in high-income countries has event-free surviv... more Acute lymphoid leukemia is a childhood cancer that in high-income countries has event-free survival rates of 80% and global survival rates of 90%. In Brazil these rates are under 70%. This difference may be due to the implementation of supportive care, including the assessment of asparaginase (ASNase) activity. ASNase may cause hypersensitivity reactions and silent drug inactivation. For this reason, ASNase activity monitoring is an essential tool to ensure an effective treatment. Our aim was to implement an ASNase activity measurement technique at a hospital setting. samples from children who were given Escherichia coli-derived ASNase were collected. The results of the analyses conducted in our laboratory Hospital de Clínicas de Porto Alegre were compared to those of two institutions: Centro Infantil Boldrini and University of Munster. 262 samples were assessed. The results of the first analyses were compared with those obtained at Centro Infantil Boldrini and showed an ICC of 0.95...
SSRN Electronic Journal
Background: Our research group recently showed that the only ASNase formulation available in Braz... more Background: Our research group recently showed that the only ASNase formulation available in Brazil from 2017 to 2018 when used at the same dose and frequency as the formulation provided previously did not reach, in most cases, the serum activity considered therapeutic. Based on these data, our goal was to assess the impact of these facts on the prognosis of children with ALL at 10 different pediatric oncology centers in our country. Methods: a multicenter retrospective observational study followed by prospective follow-up. Patients aged >1 and <18 years in first-line treatment followed up at 10 referral centers of Brazil, between 2014 and 2018 who received the formulation Leuginase® were identified (Group B). For each patient, the center registered 2 patients who received ASNase in the presentation of Aginasa® exclusively (Group A). Data collection was performed by searching for medical records and registered using Redcap® software. Findings: A total of 419 patients were included; 282 in Group A and 137 in Group B. Clinical features at diagnosis were similar in both groups. Group A had a 3-year OS and EFS of 91·8% and 84·8% respectively, while Group B had a 3-year OS of 83·8% (p= 0·003) and EFS of 76·1% (p = 0·008). Interpretation: There was an impact on 3-year OS and EFS of children who received an asparaginase formulation that previously showed inferior activity in laboratory analysis. This result highlights the importance of evaluating asparaginase formulations and monitoring their activity during treatment. Funding Statement: The research was supported by FIPE/HCPA (Fundo de Incentivo a Pesquisa e Eventos do Hospital de Clinicas de Porto Alegre). Declaration of Interests: The authors declare no conflicts of interest. Ethics Approval Statement: Ethical approval to conduct this study has been granted by the Ethics Committee of Hospital de Clinicas de Porto Alegre (HCPA). Participating adults as well as those responsible for minors signed informed consents in duplicate, keeping a copy for themselves.
Bone Marrow Transplantation
In the COVID-19 scenario, patients undergoing hematopoietic stem cell transplantation (HSCT) infe... more In the COVID-19 scenario, patients undergoing hematopoietic stem cell transplantation (HSCT) infected with SARS-CoV-2 may have an increased risk of death. Through a national multicenter study, we aimed to describe the impact of COVID-19 on the survival of HSCT recipients in Brazil. Eighty-six patients with a confirmed diagnosis of SARS-CoV-2 (92% by RT-PCR) were included. There were 24 children and 62 adults receiving an autologous (n = 25) and allogeneic (n = 61) HSCT for malignant (n = 72) and non-malignant (n = 14) disorders. Twenty-six patients died, (10 on autologous (38%) and 16 patients (62%) on allogeneic group). The estimated overall survival (OS) at day 40 was 69%. Adults had decreased OS compared to children (66% vs 79%, p = 0.03). The severity of symptoms at the time of diagnosis, ECOG score, laboratory tests (C-reactive protein, urea values) were higher in patients who died (p < 0.05). In conclusion, HSCT recipients infected with SARS-CoV-2 have a high mortality rate mainly in adults and patients with critical initial COVID-19 presentation. These findings show the fragility of HSCT recipients with SARS-CoV-2 infection. Therefore, the importance of adherence to preventive measures is evident, in addition to prioritizing the vaccination of family members and the HSCT team.