Henrique Bittencourt - Academia.edu (original) (raw)

Papers by Henrique Bittencourt

Research paper thumbnail of Patient socioeconomic status as a prognostic factor for allo-SCT

Bone Marrow Transplantation, 2009

Research paper thumbnail of Talidomida e mieloma múltiplo: verificação dos efeitos terapêuticos através de parâmetros clínico e laboratoriais

Revista Brasileira De Hematologia E Hemoterapia, 2004

Nas duas últimas décadas, houve uma mudança radical na terapia e na evolução do mieloma múltiplo(... more Nas duas últimas décadas, houve uma mudança radical na terapia e na evolução do mieloma múltiplo(MM), neoplasia hematológica ainda considerada fatal. As pesquisas e investimentos em medicamentos que interferem com a fisiopatogenia e com o microambiente medular estão permitindo o controle e a regressão do clone plasmocitário maligno, mudando as perspectivas da doença. A idéia nova de usar uma droga velha, a talidomida, tem-se mostrado efetiva no MM. Em 1997, apostando nos efeitos imunomoduladores e antiangiogênicos da talidomida, foram iniciados ensaios clínicos para MM refratários. A partir daí, outras ações sobre o plasmócito e microambiente medular foram eficazes contra a doença, não somente em refratários ou recaídos, mas também como terapia de indução e/ou de manutenção da remissão. No Serviço de Hematologia do Hospital de Clínicas de Porto Alegre foram acompanhados 35 portadores de mieloma múltiplo, em uso de doses baixas (100 mg) de talidomida, pelas indicações: 13 -manutenção pós-TMO, 11 -pós-indução, 5 -recaída, 4 -refratariedade e 2 -terapia de indução. O estudo vigorou entre março/01 a dez/03. Os parâmetros avaliados foram: nível Hb, pico da imunoglobulina sérica ou urinária e o número de plasmócitos na medula óssea. As medidas foram tomadas pré-talidomida e após 3, 6 e 12 meses. A taxa de imunoglobulina foi o padrão ouro para avaliação de resposta. Os resultados: a dose terapêutica tolerada em 48% dos pacientes foi 100 mg; 65% dos tratados para induzir remissão (11 pacientes) apresentaram melhora entre 25%-50% no nível da imunoglobulina sérica; 87,5% daqueles que usaram para manutenção de remissão (13 pós-TMO/ 11 pós-indução) mantiveram o mesmo plateau inicial. Rev. bras. hematol. hemoter. 2004;26(4):245-255. Palavras-chave: Talidomida; mieloma múltiplo; antiangiogênese.

Research paper thumbnail of Leucemia Mielóide Agura: perfil de duas décadas do Serviço de Hematologia do Hospital das Clínicas de Porto Alegre - RS

Revista Brasileira De Hematologia E Hemoterapia, 2003

We have treated many AML patients in the last 20 years. We followed, between March 1980 and Decem... more We have treated many AML patients in the last 20 years. We followed, between March 1980 and December 1999, 195 patients with ages ranging from 12 to 70 years and presenting" de novo" AML, excluding the M3 subtype. In the eighties, 102 patients are on record: 47 ...

Research paper thumbnail of Outcome of Treatment in Adult Acute Lymphoblastic Leukemia in Southern Brazil Using a Modified German Multicenter Acute Lymphoblastic Leukemia Protocol

Acta Haematologica, 2002

Reports on treatment outcomes in adults with acute lymphoblastic leukemia (ALL) in Brazil are spa... more Reports on treatment outcomes in adults with acute lymphoblastic leukemia (ALL) in Brazil are sparse. To evaluate the outcome of patients with ALL managed by the public healthcare system, we studied 42 adults treated from 1990 to 1997 in the Division of Hematology at Hospital de Clínicas, Porto Alegre, Brazil. Of these patients, 14/42 were females and their median age at diagnosis was 26 (17-64) years. The diagnosis of ALL was based on cytological examination of marrow smears, and immunophenotypic and cytogenetic studies, when available. Fifty percent of the patients expressed CD10, 30% were CD10 negative and CD19 positive and 20% expressed T markers. Philadelphia chromosome was found in 4 (7.14%). The chemotherapy protocol was adapted from the German Multicenter ALL (GMALL) 02-84 protocol. The complete remission rate was 93% and the overall survival at 5 years was 41%. No particular risk factor was identified in our series. These results are comparable to the findings of other international studies.

Research paper thumbnail of Leucemia Mielóide Aguda: perfil de duas décadas do Serviço de Hematologia do Hospital de Clínicas de Porto Alegre - RS Acute Myelogenous Leukemia: two decades overview - Hematology Service Hospital de Clínicas de Porto Alegre RS

Research paper thumbnail of 81 Infections after allogeneic bone marrow transplantation (allo-BMT) in South Brazil: Low incidence of invasive fungal infections despite low-dose fluconazole prophylaxis

Biology of Blood and Marrow Transplantation, 2003

Research paper thumbnail of Clinical features and outcomes of 134 Brazilians with acute promyelocytic leukemia who received ATRA and anthracyclines

Haematologica-the Hematology Journal, 2007

Research paper thumbnail of Influence of bone marrow graft lymphocyte subsets on outcome after HLA-identical sibling transplants

Experimental Hematology, 2001

Objective. The aim of this study was to analyze bone marrow lymphocyte subsets and CD34 cell dose... more Objective. The aim of this study was to analyze bone marrow lymphocyte subsets and CD34 cell dose and their influence on the outcomes of bone marrow transplantation. Materials and Methods. Forty-eight patients (median age 30 years, range 5-54) receiving HLA-identical sibling bone marrow transplantation for hematologic malignancies were analyzed. Results. Median number (range) of nucleated cells and CD34 ϩ cells infused were 2.4 (0.4-6.0) ϫ 10 8 /kg and 3.5 (0.5-13.0) ϫ 10 6 /kg, respectively. Probability of neutrophil recovery was 97%. In a multivariate analysis, time to neutrophil recovery was shortened when a higher number of CD3/CD8 cells was infused ( Ն 1.0 ϫ 10 7 /kg) (hazard ratio [HR] ϭ 2.13, p ϭ 0.018); when the patient was female or had negative cytomegalovirus serology (HR ϭ 2.03, p ϭ 0.03; HR ϭ 0.41, p ϭ 0.009; respectively). The incidence of grade II to IV acute graft-vs-host disease (GVHD) was 47%. Infusion of Ͼ 1 ϫ 10 7 CD4 infused/kg increased the risk of acute GVHD (HR ϭ 2.86, p ϭ 0.03). Nineteen of 40 patients at risk experienced chronic GVHD, the risk of which was increased by diagnosis of chronic leukemia (p ϭ 0.03), Ͻ 2.0 ϫ 10 8 nucleated cells infused/kg (p ϭ 0.05), and a low number of all lymphocyte subsets, except CD19. Estimated 3-year survival rate was 54%. Risk of death was increased in patients receiving Ͻ 3.5 ϫ 10 6 CD34 infused/kg (HR ϭ 0.37, p ϭ 0.02). Only six patients relapsed. Conclusions. A high cell dose of CD3/CD8 is associated with faster neutrophil recovery, whereas a high cell dose of CD4 ϩ cells increases the incidence of acute GVHD. A high number of nucleated cells and CD34 ϩ cells infused was associated with decreased risk of chronic GVHD and improved survival, respectively.

Research paper thumbnail of Imatinib mesylate versus allogeneic BMT for patients with chronic myeloid leukemia in first chronic phase

Bone Marrow Transplantation, 2008

Imatinib mesylate (IM) is now first-line treatment for CML. To study the results of treatment wit... more Imatinib mesylate (IM) is now first-line treatment for CML. To study the results of treatment with IM after IFN failure/intolerance versus allogeneic BMT (allo-BMT), we retrospectively analyzed 264 patients treated for CML in first chronic phase in three different institutions. Over a 6-year period (2001)(2002)(2003)(2004)(2005)(2006), 174 patients received IM after failure of or intolerance to IFN. During the same period of time, 90 patients received an allo-BMT from an HLA-matched sibling (n ¼ 83) or an unrelated donor (n ¼ 7). The IM group was older (41 versus 33 years, Po0.001). Five-year EFS was 62% among patients receiving IM and 52% among patients undergoing allo-BMT (P ¼ 0.0002). OS at 5 years was 93% for IM-treated patients and 59% for patients undergoing allo-BMT (Po0.0001). Allo-BMT cannot be considered as first-line treatment for CML patients in first chronic phase.

Research paper thumbnail of Association of drug metabolism gene polymorphisms with toxicities, graft-versus-host disease and survival after HLA-identical sibling hematopoietic stem cell transplantation for patients with leukemia

Leukemia, 2009

Individual differences in drug efficacy or toxicity can be influenced by genetic factors. We inve... more Individual differences in drug efficacy or toxicity can be influenced by genetic factors. We investigated whether polymorphisms of pharmacogenes that interfere with metabolism of drugs used in conditioning regimen and graft-versus-host disease (GvHD) prophylaxis could be associated with outcomes after HLA-identical hematopoietic stem cell transplantation (HSCT). Pharmacogenes and their polymorphisms were studied in 107 donors and patients with leukemia receiving HSCT. Candidate genes were: P450 cytochrome family (CYP2B6), glutathione-S-transferase family (GST), multidrug-resistance gene, methylenetetrahydrofolate reductase (MTHFR) and vitamin D receptor (VDR). The end points studied were oral mucositis (OM), hemorrhagic cystitis (HC), toxicity and venoocclusive disease of the liver (VOD), GvHD, transplantationrelated mortality (TRM) and survival. Multivariate analyses, using death as a competing event, were performed adjusting for clinical factors. Among other clinical and genetic factors, polymorphisms of CYP2B6 genes that interfere with cyclophosphamide metabolism were associated with OM (recipient CYP2B6*4; P ¼ 0.0067), HC (recipient CYP2B6*2; P ¼ 0.03) and VOD (donor CYP2B6*6; P ¼ 0.03). Recipient MTHFR polymorphisms (C677T) were associated with acute GvHD (P ¼ 0.03), and recipient VDR TaqI with TRM and overall survival (P ¼ 0.006 and P ¼ 0.04, respectively).Genetic factors that interfere with drug metabolisms are associated with treatment-related toxicities, GvHD and survival after HLA-identical HSCT in patients with leukemia and should be investigated prospectively. Pharmacogenes polymorphisms and outcomes after HSCT V Rocha et al Pharmacogenes polymorphisms and outcomes after HSCT V Rocha et al 556 Leukemia

Research paper thumbnail of Transplante alogênico de células-tronco hematopoéticas em leucemias agudas: a experiência de dez anos do Hospital das Clínicas da UFMG

Revista Brasileira De Hematologia E Hemoterapia, 2010

... 2000;96(13):4075-83. 9. Gratwohl A, Baldomero H, Schwendener A, Gratwohl M, Apperley J, Niede... more ... 2000;96(13):4075-83. 9. Gratwohl A, Baldomero H, Schwendener A, Gratwohl M, Apperley J, Niederwieser D, et al. Predictability of hematopoietic stem cell transplantation rates. ... Blood. 2002;100(3):761-7. 21. Cutler C, Giri S, Jeyapalan S, Paniagua D, Viswanathan A, Antin JH. ...

Research paper thumbnail of The use of imatinib mesylate has no adverse effects on the heart function. Results of a pilot study in patients with chronic myeloid leukemia

Leukemia Research, 2011

To investigate cardiac effects of imatinib at an extended follow-up (median 12.4 months), 12 chro... more To investigate cardiac effects of imatinib at an extended follow-up (median 12.4 months), 12 chronic myeloid leukemia patients underwent cardiac screening. No significant changes on the frequency of cardiovascular signs and symptoms, electrocardiographic abnormalities, echocardiographic measurements and BNP levels were observed. Median ejection fraction was 67% at baseline versus 68% at follow-up (median intra-patient change 0.5%). Median BNP levels were 8.3 versus 7.3 pg/mL (median intra-patient change 0.2 pg/mL). Troponin I measures were below the lower limit of detection, whereas strain measures were similar to healthy control. This pilot study suggests that it is probably safe to perform cardiac monitoring on an annual basis.

Research paper thumbnail of Host defense and inflammatory gene polymorphisms are associated with outcomes after HLA-identical sibling bone marrow transplantation

Presented in part at the Annual Meeting of the American Society of with outcomes after HLA-identi... more Presented in part at the Annual Meeting of the American Society of with outcomes after HLA-identical sibling bone marrow transplantation: Host defense and inflammatory gene polymorphisms are associated http://bloodjournal.hematologylibrary.org/content/100/12/3908.full.html Updated information and services can be found at: (3753 articles) Clinical Trials and Observations Articles on similar topics can be found in the following Blood collections http://bloodjournal.hematologylibrary.org/site/misc/rights.xhtml#repub_requests Information about reproducing this article in parts or in its entirety may be found online at: http://bloodjournal.hematologylibrary.org/site/misc/rights.xhtml#reprints Information about ordering reprints may be found online at: http://bloodjournal.hematologylibrary.org/site/subscriptions/index.xhtml Information about subscriptions and ASH membership may be found online at: We made the hypothesis that donor and recipient gene polymorphisms that drive the host response to microorganisms could be associated with infections after bone marrow transplantation (BMT). HLAidentical BMT was performed for patients with acute (n ‫؍‬ 39) or chronic leukemia (n ‫؍‬ 68). Genotyping was performed in 107 D/R DNA pairs for gene polymorphisms of cytokines (tumor necrosis factor-␣ [TNF-␣] and TNF-␤, interleukin-1 receptor antagonist [IL-1Ra], IL-6, and IL-10), adhesion molecules (CD31 and CD54), Fc␥receptors (Fc␥RIIa, IIIa, IIIb), mannose-binding lectin (MBL), and myeloperoxidase (

Research paper thumbnail of CYSTECTOMY FOR SEVERE HEMORRHAGIC CYSTITIS IN ALLOGENEIC STEM CELL TRANSPLANT RECIPIENTS1

Transplantation, 2000

Hemorrhagic cystitis (HC) is a common complication following allogeneic stem cell transplantation... more Hemorrhagic cystitis (HC) is a common complication following allogeneic stem cell transplantation (SCT). In rare cases, it can be severe, inducing kidney failure and sepsis, and become life-threatening. We report three cases of severe HC in stem cell transplant recipients. Risk factors and the management of these patients were studied, as well as severe HC cases reported in the literature. All three patients received high-dose cyclophosphamide in addition to total body irradiation or busulfan in their preparative regimen. They underwent allogeneic SCT, one of them from unrelated cord blood. BK viruria was detected in two cases at the onset of hematuria. HC lasted for more than 3 months, resulting in urinary tract obstruction and sepsis. Ultimately, cystectomy was the last therapeutic procedure available to treat this life-threatening complication. We describe three patients, among a total of more than 1300 patients treated in our unit by allogeneic bone marrow transplantation, in whom HC was severe and long lasting enough to require cystectomy as a life-saving procedure.

Research paper thumbnail of Influence of CD34+ marrow cell dose on outcome of HLA-identical sibling allogeneic bone marrow transplants in patients with chronic myeloid leukaemia

Bone Marrow Transplantation, 2001

In order to study the influence of bone marrow CD34+ cell dose on the outcome of allogeneic bone ... more In order to study the influence of bone marrow CD34+ cell dose on the outcome of allogeneic bone marrow transplantation (BMT), we analysed the results of BMT from HLA-identical siblings donors in 50 patients with chronic myeloid leukaemia (CML). The median numbers of nucleated cells (NC) and CD34+ cells infused were 2.18 × 108/kg (0.05–4.14 × 108/kg) and 3.12 ×

Research paper thumbnail of Autologous hematopoetic stem cell transplantation for HIV-related Non-Hodgkin's Lymphomas (NHL

Brazilian Journal of Infectious Diseases, 2005

Research paper thumbnail of Treatment of T-prolymphocytic leukemia with nonmyeloablative allogeneic stem cell transplantation

European Journal of Haematology, 2001

T-prolymphocytic leukemia (T-PLL) is a rare disease of the elderly characterized by a high white ... more T-prolymphocytic leukemia (T-PLL) is a rare disease of the elderly characterized by a high white blood cell count and organomegaly, and is currently incurable. Our aim was to elicit graft-versus-leukemia reactions in a patient with T-PLL. A 52-yr-old woman with refractory T-PLL underwent a nonmyeloablative regimen followed by allogeneic peripheral blood stem cell transplantation (a "minitransplant") from her HLA-matched sibling. There was no treatment related toxicity other than neutropenia. Engraftment was successful. The patient experienced no graft-versus-host disease (GVHD) at any time but, on day 84 after transplantation, had a relapse in the central nervous system. Despite infusion of donor lymphocytes and intralumbar chemotherapy, she died on day 157 of systemic disease. The reasons why treatment may have failed are discussed (nature of disease, disease progression, treatment schedule).

Research paper thumbnail of Patient socioeconomic status as a prognostic factor for allo-SCT

Bone Marrow Transplantation, 2009

Research paper thumbnail of Talidomida e mieloma múltiplo: verificação dos efeitos terapêuticos através de parâmetros clínico e laboratoriais

Revista Brasileira De Hematologia E Hemoterapia, 2004

Nas duas últimas décadas, houve uma mudança radical na terapia e na evolução do mieloma múltiplo(... more Nas duas últimas décadas, houve uma mudança radical na terapia e na evolução do mieloma múltiplo(MM), neoplasia hematológica ainda considerada fatal. As pesquisas e investimentos em medicamentos que interferem com a fisiopatogenia e com o microambiente medular estão permitindo o controle e a regressão do clone plasmocitário maligno, mudando as perspectivas da doença. A idéia nova de usar uma droga velha, a talidomida, tem-se mostrado efetiva no MM. Em 1997, apostando nos efeitos imunomoduladores e antiangiogênicos da talidomida, foram iniciados ensaios clínicos para MM refratários. A partir daí, outras ações sobre o plasmócito e microambiente medular foram eficazes contra a doença, não somente em refratários ou recaídos, mas também como terapia de indução e/ou de manutenção da remissão. No Serviço de Hematologia do Hospital de Clínicas de Porto Alegre foram acompanhados 35 portadores de mieloma múltiplo, em uso de doses baixas (100 mg) de talidomida, pelas indicações: 13 -manutenção pós-TMO, 11 -pós-indução, 5 -recaída, 4 -refratariedade e 2 -terapia de indução. O estudo vigorou entre março/01 a dez/03. Os parâmetros avaliados foram: nível Hb, pico da imunoglobulina sérica ou urinária e o número de plasmócitos na medula óssea. As medidas foram tomadas pré-talidomida e após 3, 6 e 12 meses. A taxa de imunoglobulina foi o padrão ouro para avaliação de resposta. Os resultados: a dose terapêutica tolerada em 48% dos pacientes foi 100 mg; 65% dos tratados para induzir remissão (11 pacientes) apresentaram melhora entre 25%-50% no nível da imunoglobulina sérica; 87,5% daqueles que usaram para manutenção de remissão (13 pós-TMO/ 11 pós-indução) mantiveram o mesmo plateau inicial. Rev. bras. hematol. hemoter. 2004;26(4):245-255. Palavras-chave: Talidomida; mieloma múltiplo; antiangiogênese.

Research paper thumbnail of Leucemia Mielóide Agura: perfil de duas décadas do Serviço de Hematologia do Hospital das Clínicas de Porto Alegre - RS

Revista Brasileira De Hematologia E Hemoterapia, 2003

We have treated many AML patients in the last 20 years. We followed, between March 1980 and Decem... more We have treated many AML patients in the last 20 years. We followed, between March 1980 and December 1999, 195 patients with ages ranging from 12 to 70 years and presenting" de novo" AML, excluding the M3 subtype. In the eighties, 102 patients are on record: 47 ...

Research paper thumbnail of Outcome of Treatment in Adult Acute Lymphoblastic Leukemia in Southern Brazil Using a Modified German Multicenter Acute Lymphoblastic Leukemia Protocol

Acta Haematologica, 2002

Reports on treatment outcomes in adults with acute lymphoblastic leukemia (ALL) in Brazil are spa... more Reports on treatment outcomes in adults with acute lymphoblastic leukemia (ALL) in Brazil are sparse. To evaluate the outcome of patients with ALL managed by the public healthcare system, we studied 42 adults treated from 1990 to 1997 in the Division of Hematology at Hospital de Clínicas, Porto Alegre, Brazil. Of these patients, 14/42 were females and their median age at diagnosis was 26 (17-64) years. The diagnosis of ALL was based on cytological examination of marrow smears, and immunophenotypic and cytogenetic studies, when available. Fifty percent of the patients expressed CD10, 30% were CD10 negative and CD19 positive and 20% expressed T markers. Philadelphia chromosome was found in 4 (7.14%). The chemotherapy protocol was adapted from the German Multicenter ALL (GMALL) 02-84 protocol. The complete remission rate was 93% and the overall survival at 5 years was 41%. No particular risk factor was identified in our series. These results are comparable to the findings of other international studies.

Research paper thumbnail of Leucemia Mielóide Aguda: perfil de duas décadas do Serviço de Hematologia do Hospital de Clínicas de Porto Alegre - RS Acute Myelogenous Leukemia: two decades overview - Hematology Service Hospital de Clínicas de Porto Alegre RS

Research paper thumbnail of 81 Infections after allogeneic bone marrow transplantation (allo-BMT) in South Brazil: Low incidence of invasive fungal infections despite low-dose fluconazole prophylaxis

Biology of Blood and Marrow Transplantation, 2003

Research paper thumbnail of Clinical features and outcomes of 134 Brazilians with acute promyelocytic leukemia who received ATRA and anthracyclines

Haematologica-the Hematology Journal, 2007

Research paper thumbnail of Influence of bone marrow graft lymphocyte subsets on outcome after HLA-identical sibling transplants

Experimental Hematology, 2001

Objective. The aim of this study was to analyze bone marrow lymphocyte subsets and CD34 cell dose... more Objective. The aim of this study was to analyze bone marrow lymphocyte subsets and CD34 cell dose and their influence on the outcomes of bone marrow transplantation. Materials and Methods. Forty-eight patients (median age 30 years, range 5-54) receiving HLA-identical sibling bone marrow transplantation for hematologic malignancies were analyzed. Results. Median number (range) of nucleated cells and CD34 ϩ cells infused were 2.4 (0.4-6.0) ϫ 10 8 /kg and 3.5 (0.5-13.0) ϫ 10 6 /kg, respectively. Probability of neutrophil recovery was 97%. In a multivariate analysis, time to neutrophil recovery was shortened when a higher number of CD3/CD8 cells was infused ( Ն 1.0 ϫ 10 7 /kg) (hazard ratio [HR] ϭ 2.13, p ϭ 0.018); when the patient was female or had negative cytomegalovirus serology (HR ϭ 2.03, p ϭ 0.03; HR ϭ 0.41, p ϭ 0.009; respectively). The incidence of grade II to IV acute graft-vs-host disease (GVHD) was 47%. Infusion of Ͼ 1 ϫ 10 7 CD4 infused/kg increased the risk of acute GVHD (HR ϭ 2.86, p ϭ 0.03). Nineteen of 40 patients at risk experienced chronic GVHD, the risk of which was increased by diagnosis of chronic leukemia (p ϭ 0.03), Ͻ 2.0 ϫ 10 8 nucleated cells infused/kg (p ϭ 0.05), and a low number of all lymphocyte subsets, except CD19. Estimated 3-year survival rate was 54%. Risk of death was increased in patients receiving Ͻ 3.5 ϫ 10 6 CD34 infused/kg (HR ϭ 0.37, p ϭ 0.02). Only six patients relapsed. Conclusions. A high cell dose of CD3/CD8 is associated with faster neutrophil recovery, whereas a high cell dose of CD4 ϩ cells increases the incidence of acute GVHD. A high number of nucleated cells and CD34 ϩ cells infused was associated with decreased risk of chronic GVHD and improved survival, respectively.

Research paper thumbnail of Imatinib mesylate versus allogeneic BMT for patients with chronic myeloid leukemia in first chronic phase

Bone Marrow Transplantation, 2008

Imatinib mesylate (IM) is now first-line treatment for CML. To study the results of treatment wit... more Imatinib mesylate (IM) is now first-line treatment for CML. To study the results of treatment with IM after IFN failure/intolerance versus allogeneic BMT (allo-BMT), we retrospectively analyzed 264 patients treated for CML in first chronic phase in three different institutions. Over a 6-year period (2001)(2002)(2003)(2004)(2005)(2006), 174 patients received IM after failure of or intolerance to IFN. During the same period of time, 90 patients received an allo-BMT from an HLA-matched sibling (n ¼ 83) or an unrelated donor (n ¼ 7). The IM group was older (41 versus 33 years, Po0.001). Five-year EFS was 62% among patients receiving IM and 52% among patients undergoing allo-BMT (P ¼ 0.0002). OS at 5 years was 93% for IM-treated patients and 59% for patients undergoing allo-BMT (Po0.0001). Allo-BMT cannot be considered as first-line treatment for CML patients in first chronic phase.

Research paper thumbnail of Association of drug metabolism gene polymorphisms with toxicities, graft-versus-host disease and survival after HLA-identical sibling hematopoietic stem cell transplantation for patients with leukemia

Leukemia, 2009

Individual differences in drug efficacy or toxicity can be influenced by genetic factors. We inve... more Individual differences in drug efficacy or toxicity can be influenced by genetic factors. We investigated whether polymorphisms of pharmacogenes that interfere with metabolism of drugs used in conditioning regimen and graft-versus-host disease (GvHD) prophylaxis could be associated with outcomes after HLA-identical hematopoietic stem cell transplantation (HSCT). Pharmacogenes and their polymorphisms were studied in 107 donors and patients with leukemia receiving HSCT. Candidate genes were: P450 cytochrome family (CYP2B6), glutathione-S-transferase family (GST), multidrug-resistance gene, methylenetetrahydrofolate reductase (MTHFR) and vitamin D receptor (VDR). The end points studied were oral mucositis (OM), hemorrhagic cystitis (HC), toxicity and venoocclusive disease of the liver (VOD), GvHD, transplantationrelated mortality (TRM) and survival. Multivariate analyses, using death as a competing event, were performed adjusting for clinical factors. Among other clinical and genetic factors, polymorphisms of CYP2B6 genes that interfere with cyclophosphamide metabolism were associated with OM (recipient CYP2B6*4; P ¼ 0.0067), HC (recipient CYP2B6*2; P ¼ 0.03) and VOD (donor CYP2B6*6; P ¼ 0.03). Recipient MTHFR polymorphisms (C677T) were associated with acute GvHD (P ¼ 0.03), and recipient VDR TaqI with TRM and overall survival (P ¼ 0.006 and P ¼ 0.04, respectively).Genetic factors that interfere with drug metabolisms are associated with treatment-related toxicities, GvHD and survival after HLA-identical HSCT in patients with leukemia and should be investigated prospectively. Pharmacogenes polymorphisms and outcomes after HSCT V Rocha et al Pharmacogenes polymorphisms and outcomes after HSCT V Rocha et al 556 Leukemia

Research paper thumbnail of Transplante alogênico de células-tronco hematopoéticas em leucemias agudas: a experiência de dez anos do Hospital das Clínicas da UFMG

Revista Brasileira De Hematologia E Hemoterapia, 2010

... 2000;96(13):4075-83. 9. Gratwohl A, Baldomero H, Schwendener A, Gratwohl M, Apperley J, Niede... more ... 2000;96(13):4075-83. 9. Gratwohl A, Baldomero H, Schwendener A, Gratwohl M, Apperley J, Niederwieser D, et al. Predictability of hematopoietic stem cell transplantation rates. ... Blood. 2002;100(3):761-7. 21. Cutler C, Giri S, Jeyapalan S, Paniagua D, Viswanathan A, Antin JH. ...

Research paper thumbnail of The use of imatinib mesylate has no adverse effects on the heart function. Results of a pilot study in patients with chronic myeloid leukemia

Leukemia Research, 2011

To investigate cardiac effects of imatinib at an extended follow-up (median 12.4 months), 12 chro... more To investigate cardiac effects of imatinib at an extended follow-up (median 12.4 months), 12 chronic myeloid leukemia patients underwent cardiac screening. No significant changes on the frequency of cardiovascular signs and symptoms, electrocardiographic abnormalities, echocardiographic measurements and BNP levels were observed. Median ejection fraction was 67% at baseline versus 68% at follow-up (median intra-patient change 0.5%). Median BNP levels were 8.3 versus 7.3 pg/mL (median intra-patient change 0.2 pg/mL). Troponin I measures were below the lower limit of detection, whereas strain measures were similar to healthy control. This pilot study suggests that it is probably safe to perform cardiac monitoring on an annual basis.

Research paper thumbnail of Host defense and inflammatory gene polymorphisms are associated with outcomes after HLA-identical sibling bone marrow transplantation

Presented in part at the Annual Meeting of the American Society of with outcomes after HLA-identi... more Presented in part at the Annual Meeting of the American Society of with outcomes after HLA-identical sibling bone marrow transplantation: Host defense and inflammatory gene polymorphisms are associated http://bloodjournal.hematologylibrary.org/content/100/12/3908.full.html Updated information and services can be found at: (3753 articles) Clinical Trials and Observations Articles on similar topics can be found in the following Blood collections http://bloodjournal.hematologylibrary.org/site/misc/rights.xhtml#repub_requests Information about reproducing this article in parts or in its entirety may be found online at: http://bloodjournal.hematologylibrary.org/site/misc/rights.xhtml#reprints Information about ordering reprints may be found online at: http://bloodjournal.hematologylibrary.org/site/subscriptions/index.xhtml Information about subscriptions and ASH membership may be found online at: We made the hypothesis that donor and recipient gene polymorphisms that drive the host response to microorganisms could be associated with infections after bone marrow transplantation (BMT). HLAidentical BMT was performed for patients with acute (n ‫؍‬ 39) or chronic leukemia (n ‫؍‬ 68). Genotyping was performed in 107 D/R DNA pairs for gene polymorphisms of cytokines (tumor necrosis factor-␣ [TNF-␣] and TNF-␤, interleukin-1 receptor antagonist [IL-1Ra], IL-6, and IL-10), adhesion molecules (CD31 and CD54), Fc␥receptors (Fc␥RIIa, IIIa, IIIb), mannose-binding lectin (MBL), and myeloperoxidase (

Research paper thumbnail of CYSTECTOMY FOR SEVERE HEMORRHAGIC CYSTITIS IN ALLOGENEIC STEM CELL TRANSPLANT RECIPIENTS1

Transplantation, 2000

Hemorrhagic cystitis (HC) is a common complication following allogeneic stem cell transplantation... more Hemorrhagic cystitis (HC) is a common complication following allogeneic stem cell transplantation (SCT). In rare cases, it can be severe, inducing kidney failure and sepsis, and become life-threatening. We report three cases of severe HC in stem cell transplant recipients. Risk factors and the management of these patients were studied, as well as severe HC cases reported in the literature. All three patients received high-dose cyclophosphamide in addition to total body irradiation or busulfan in their preparative regimen. They underwent allogeneic SCT, one of them from unrelated cord blood. BK viruria was detected in two cases at the onset of hematuria. HC lasted for more than 3 months, resulting in urinary tract obstruction and sepsis. Ultimately, cystectomy was the last therapeutic procedure available to treat this life-threatening complication. We describe three patients, among a total of more than 1300 patients treated in our unit by allogeneic bone marrow transplantation, in whom HC was severe and long lasting enough to require cystectomy as a life-saving procedure.

Research paper thumbnail of Influence of CD34+ marrow cell dose on outcome of HLA-identical sibling allogeneic bone marrow transplants in patients with chronic myeloid leukaemia

Bone Marrow Transplantation, 2001

In order to study the influence of bone marrow CD34+ cell dose on the outcome of allogeneic bone ... more In order to study the influence of bone marrow CD34+ cell dose on the outcome of allogeneic bone marrow transplantation (BMT), we analysed the results of BMT from HLA-identical siblings donors in 50 patients with chronic myeloid leukaemia (CML). The median numbers of nucleated cells (NC) and CD34+ cells infused were 2.18 × 108/kg (0.05–4.14 × 108/kg) and 3.12 ×

Research paper thumbnail of Autologous hematopoetic stem cell transplantation for HIV-related Non-Hodgkin's Lymphomas (NHL

Brazilian Journal of Infectious Diseases, 2005

Research paper thumbnail of Treatment of T-prolymphocytic leukemia with nonmyeloablative allogeneic stem cell transplantation

European Journal of Haematology, 2001

T-prolymphocytic leukemia (T-PLL) is a rare disease of the elderly characterized by a high white ... more T-prolymphocytic leukemia (T-PLL) is a rare disease of the elderly characterized by a high white blood cell count and organomegaly, and is currently incurable. Our aim was to elicit graft-versus-leukemia reactions in a patient with T-PLL. A 52-yr-old woman with refractory T-PLL underwent a nonmyeloablative regimen followed by allogeneic peripheral blood stem cell transplantation (a "minitransplant") from her HLA-matched sibling. There was no treatment related toxicity other than neutropenia. Engraftment was successful. The patient experienced no graft-versus-host disease (GVHD) at any time but, on day 84 after transplantation, had a relapse in the central nervous system. Despite infusion of donor lymphocytes and intralumbar chemotherapy, she died on day 157 of systemic disease. The reasons why treatment may have failed are discussed (nature of disease, disease progression, treatment schedule).