Asunto(s)
Linfoma Folicular/diagnóstico , Linfoma Folicular/genética , Polimorfismo de Nucleótido Simple , Factor A de Crecimiento Endotelial Vascular/genética , Adulto , Anticuerpos Monoclonales de Origen Murino/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Estudios de Casos y Controles , Ciclofosfamida/uso terapéutico , Doxorrubicina/uso terapéutico , Femenino , Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Humanos , Linfoma Folicular/tratamiento farmacológico , Linfoma Folicular/mortalidad , Masculino , Persona de Mediana Edad , Prednisona/uso terapéutico , Pronóstico , Rituximab , Análisis de Supervivencia , Resultado del Tratamiento , Vincristina/uso terapéuticoRESUMEN
It is well established that interleukin-6 (IL-6) is an essential growth factor for multiple myeloma (MM) and patients with increased IL-6 levels have a poor prognosis. In healthy subjects, the presence of the C allele at a polymorphic site (-174 G/C) of the IL-6 gene is related to low IL-6 levels. In view of the potential association of this particular polymorphism with IL-6 concentration, and the relevance of IL-6 in MM pathogenesis, the objective of the present study was to investigate the prevalence of IL-6 (-174 G/C) promoter polymorphism and its association with development of MM in Brazilian individuals. We investigated the prevalence of these alleles in 52 patients and 60 healthy subjects (matched by age, sex, and race) of a Brazilian population. Thirty patients were male (42.4%), 24 (46.2%) were white and the median age at diagnosis was 58.5 years (range: 28 to 84 years). To determine the IL-6 (-174 G/C) polymorphism, molecular analysis was performed by polymerase chain reaction followed by endonuclease restriction digestion. The genotype distributions observed in the group of patients were 4% CC, 42% GC and 54% GG. The C allele frequency was 0.25. These results were similar to the control group, suggesting no impact of this polymorphism on the susceptibility to MM.
Asunto(s)
Interleucina-6/genética , Mieloma Múltiple/genética , Polimorfismo Genético , Regiones Promotoras Genéticas/genética , Adulto , Anciano , Anciano de 80 o más Años , Alelos , Femenino , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Reacción en Cadena de la PolimerasaRESUMEN
It is well established that interleukin-6 (IL-6) is an essential growth factor for multiple myeloma (MM) and patients with increased IL-6 levels have a poor prognosis. In healthy subjects, the presence of the C allele at a polymorphic site (-174 G/C) of the IL-6 gene is related to low IL-6 levels. In view of the potential association of this particular polymorphism with IL-6 concentration, and the relevance of IL-6 in MM pathogenesis, the objective of the present study was to investigate the prevalence of IL-6 (-174 G/C) promoter polymorphism and its association with development of MM in Brazilian individuals. We investigated the prevalence of these alleles in 52 patients and 60 healthy subjects (matched by age, sex, and race) of a Brazilian population. Thirty patients were male (42.4 percent), 24 (46.2 percent) were white and the median age at diagnosis was 58.5 years (range: 28 to 84 years). To determine the IL-6 (-174 G/C) polymorphism, molecular analysis was performed by polymerase chain reaction followed by endonuclease restriction digestion. The genotype distributions observed in the group of patients were 4 percent CC, 42 percent GC and 54 percent GG. The C allele frequency was 0.25. These results were similar to the control group, suggesting no impact of this polymorphism on the susceptibility to MM.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano de 80 o más Años , /genética , Mieloma Múltiple/genética , Polimorfismo Genético , Regiones Promotoras Genéticas , Alelos , Predisposición Genética a la Enfermedad , Genotipo , Reacción en Cadena de la PolimerasaRESUMEN
Adult T-cell leukemia/lymphoma (ATLL) is a malignant proliferation of mature helper T lymphocytes,(1) and is caused by human T-lymphotropic virus type I (HTLV-I);(2) an HTLV-I infection endemic in the Caribbean, south-western Japan, South America and Africa.(3,4) Seroepidemiological studies suggest that it is also endemic in Brazil.(5) Although carriers of HTLV-I show polyclonal integration of virus in T lymphocytes, only patients with ATLL of various subtypes show monoclonal integration of HTLV-I in tumor cells.(6,7) Cutaneous T-cell lymphomas (CTCL) are a group of primary cutaneous lymphoproliferative diseases(8) with unknown etiology.(9) The two most common presentations of CTCL are mycosis fungoides (MF) and Sézary syndrome (SS).(10-13) However, both CTCL categories can easily resemble ATLL. Therefore, in HTLV-I endemic areas, differentiation between ATLL and CTCL must be performed, as they have different prognoses and treatment approaches.(14).
Asunto(s)
Leucemia-Linfoma de Células T del Adulto/diagnóstico , Adulto , Antineoplásicos/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Brasil , Ciclofosfamida/uso terapéutico , ADN Viral/análisis , Doxorrubicina/uso terapéutico , Enfermedades Endémicas , Humanos , Interferón-alfa/uso terapéutico , Leucemia-Linfoma de Células T del Adulto/tratamiento farmacológico , Masculino , Recurrencia Local de Neoplasia , Reacción en Cadena de la Polimerasa , Prednisona/uso terapéutico , Vincristina/uso terapéutico , Zidovudina/uso terapéuticoRESUMEN
The biologic basis of the negative prognosis of plasmablastic myeloma is not fully understood. To determine whether histologically aggressive multiple myeloma (MM) is associated with a more angiogenic marrow environment, bone marrow samples from 50 recently diagnosed MM patients were evaluated. Twelve percent (6/50) of patients presented plasmablastic MM, and this feature correlated with moderate/strong intensity of vascular endothelial growth factor staining of plasma cells (P = 0.036). Although plasmablastic MM was not associated with increasing of microvessel density, this new evidence of increased expression of vascular endothelial growth factor on plasmablasts suggests that the adverse prognosis conferred by plasmablastic disease may be due, at least in part, to secretion of this angiogenic cytokine, also suggesting that the subset of MM patients with plasmablastic features may derive particular benefit from antiangiogenic therapies.
Asunto(s)
Médula Ósea/irrigación sanguínea , Mieloma Múltiple/irrigación sanguínea , Neovascularización Patológica/patología , Factor A de Crecimiento Endotelial Vascular/análisis , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/análisis , Biopsia , Médula Ósea/patología , Femenino , Humanos , Inmunohistoquímica , Masculino , Microcirculación , Persona de Mediana Edad , Mieloma Múltiple/metabolismo , Mieloma Múltiple/patología , PronósticoRESUMEN
The biologic basis of the negative prognosis of plasmablastic myeloma is not fully understood. To determine whether histologically aggressive multiple myeloma (MM) is associated with a more angiogenic marrow environment, bone marrow samples from 50 recently diagnosed MM patients were evaluated. Twelve percent (6/50) of patients presented plasmablastic MM, and this feature correlated with moderate/strong intensity of vascular endothelial growth factor staining of plasma cells (P = 0.036). Although plasmablastic MM was not associated with increasing of microvessel density, this new evidence of increased expression of vascular endothelial growth factor on plasmablasts suggests that the adverse prognosis conferred by plasmablastic disease may be due, at least in part, to secretion of this angiogenic cytokine, also suggesting that the subset of MM patients with plasmablastic features may derive particular benefit from antiangiogenic therapies.
Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Femenino , Persona de Mediana Edad , Humanos , Masculino , Factor A de Crecimiento Endotelial Vascular/análisis , Médula Ósea/irrigación sanguínea , Mieloma Múltiple/irrigación sanguínea , Neovascularización Patológica/patología , Biopsia , Inmunohistoquímica , Microcirculación , Biomarcadores de Tumor/análisis , Médula Ósea/patología , Mieloma Múltiple/metabolismo , Mieloma Múltiple/patología , PronósticoRESUMEN
Objetivo. Relato de três casos do GLLM acompanhados pela Disciplina de Hematologia e Hemoterapia da Unifesp-EPM que tiveram boa resposta à terapêutica e evoluçao favorável. Métodos. Após confirmaçao histológica e histoquímica, os pacientes foram submetidos à tratamento quimio e radioterápico com boa resposta terapêutica. Resultados. Atualmente estes pacientes encontram-se em remissao total da doença, com sobrevida média de 45 meses. Conclusao. Levando-se em consideraçao nossa pequena experiência, acreditamos que o tratamento radioterápico e a abordagem quimioterápica inicial agressiva sao fundamentais para uma boa evoluçao deste tipo de linfoma.
Asunto(s)
Femenino , Humanos , Adulto , Persona de Mediana Edad , Granuloma Letal de la Línea Media/diagnóstico , Granuloma Letal de la Línea Media/terapia , Granuloma Letal de la Línea Media , Estadificación de NeoplasiasRESUMEN
Os autores relatam um caso de leucemia mielóide aguda (LMA) que apresentava, ao diagnóstico, basofilia no sangue periférico e cariótipo com presença do cromossomo Filadélfia (Ph1). Após um ano de tratamento com quimioterapia intensiva e em fase de remissao clínica e hematológica, a análise molecular pela técnica da reaçao em cadeia da polimerase-trasncriptase reversa (RT-PCR) revelou presença de doença residual (rearranjo b2-a2). A seguir, o paciente apresentou primeira recidiva como LMA e, após a remissao, evoluiu com quadro hematológico sugestivo de leucemia mielóide crônica (LMC) em fase crônica. Após dez meses, apresentou nova recidiva da LMA. Os autores discutem a dificuldade do diagnóstico diferencial entre LMA Ph1-positivo de novo e crise blástica mielóide como primeira manifestaçao clínica da LMC, baseados nos aspectos clínicos e moleculares.
Asunto(s)
Adulto , Femenino , Humanos , Leucemia Mielógena Crónica BCR-ABL Positiva/diagnóstico , Recurrencia , Leucemia Mielógena Crónica BCR-ABL Positiva/genética , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Reacción en Cadena de la Polimerasa , ADN Polimerasa Dirigida por ARN , Resultado Fatal , Diagnóstico DiferencialRESUMEN
Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by the presence of a reciprocal translocation between chromosomes 9 and 22 in at least 95 per cent of cases. At the molecular level, this translocation results in the activation of the ABL oncogene of chromosome 9, which becomes contiguous with the 5'end of the BCR gene on chromosome 22. The breakpoint usually occurs between exons 2 and 3 (b2-a2 rearrangement), or 3 and 4 (b3-a2 rearrangement) of the major breakpoint cluster region (M-BCR) of the BCR gene. The aim of the present study was to characterize the type of BCR-ABL transcript in 32 patients with CML using the reverse transcriptase-polymerase chaim reaction (RT-PCR) and to determine if this type of rearrangement is related to the survival of the patients. Our results confirmed that RT-PCR is more sensitive than cytogenetic analysis for identifying the Philadelphia (Ph1) chromosome (96.9 per cent vs 79.3 per cent). The frequencies of b2-a2 and b3-a2 rearrangements were 28.1 per cent and 65.7 per cent, respectively. The survival of patients presenting the b2-a2 or the b3-a2 rearrangement was not significantly different (P = 0.27750). The data suggest that the type of transcript has no prognostic value for CML patients.