RESUMO

Infant acute lymphoblastic leukemia (IALL) is characterized by mixed lineage leukemia (MLL) gene rearrangements, unique gene expression profiles, poor prognosis, and drug resistance. One exception is cytosine arabinoside (Ara-C) to which IALL cells seem to be more sensitive. We quantified mRNA expression of Ara-C key enzymes in leukemic lymphoblasts from 64 Brazilian ALL children, 15 of them presenting MLL gene rearrangement, and correlated it with clinical and biological features. The diagnosis was based on morphological criteria and immunophenotyping using monoclonal antibodies. MLL gene rearrangements were detected by conventional cytogenetic analysis, RT-PCR and/or fluorescence in situ hybridization. The DCK and HENT1 expression levels were determined by real-time quantitative PCR using SYBR Green I. Relative quantification was made by the standard curve method. The results were analyzed by Mann-Whitney and Fisher exact tests. A P value of

Assuntos

Antimetabólitos Antineoplásicos/metabolismo , Citarabina/metabolismo , Rearranjo Gênico/genética , Proteína de Leucina Linfoide-Mieloide/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Antimetabólitos Antineoplásicos/uso terapêutico , Estudos de Casos e Controles , Criança , Pré-Escolar , Citarabina/uso terapêutico , Desoxicitidina Quinase/efeitos dos fármacos , Desoxicitidina Quinase/genética , Transportador Equilibrativo 1 de Nucleosídeo/efeitos dos fármacos , Transportador Equilibrativo 1 de Nucleosídeo/genética , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Lactente , Masculino , Proteína de Leucina Linfoide-Mieloide/efeitos dos fármacos , Neoplasia Residual , Reação em Cadeia da Polimerase/métodos , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/enzimologia , RNA Mensageiro/análise , Fatores de Tempo

RESUMO

Infant acute lymphoblastic leukemia (IALL) is characterized by mixed lineage leukemia (MLL) gene rearrangements, unique gene expression profiles, poor prognosis, and drug resistance. One exception is cytosine arabinoside (Ara-C) to which IALL cells seem to be more sensitive. We quantified mRNA expression of Ara-C key enzymes in leukemic lymphoblasts from 64 Brazilian ALL children, 15 of them presenting MLL gene rearrangement, and correlated it with clinical and biological features. The diagnosis was based on morphological criteria and immunophenotyping using monoclonal antibodies. MLL gene rearrangements were detected by conventional cytogenetic analysis, RT-PCR and/or fluorescence in situ hybridization. The DCK and HENT1 expression levels were determined by real-time quantitative PCR using SYBR Green I. Relative quantification was made by the standard curve method. The results were analyzed by Mann-Whitney and Fisher exact tests. A P value of ú0.05 was considered to be statistically significant. DCK and HENT1 expression levels were significantly lower in children with MLL gene-rearranged ALL compared to children with MLL germ line ALL (P = 0.0003 and 0.03, respectively). Our results differ from previous ones concerning HENT1 mRNA expression that observed a higher expression level in MLL gene-rearranged leukemias. In conclusion, the expression of the genes related to Ara-C metabolism was lower in MLL-positive children in the sample studied, suggesting the presence of population differences in the expression profile of these genes especially for HENT1.

Assuntos

Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Antimetabólitos Antineoplásicos/uso terapêutico , Citarabina/uso terapêutico , Rearranjo Gênico/genética , Proteína de Leucina Linfoide-Mieloide/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras , Estudos de Casos e Controles , Desoxicitidina Quinase/efeitos dos fármacos , Desoxicitidina Quinase/genética , Transportador Equilibrativo 1 de Nucleosídeo/efeitos dos fármacos , Transportador Equilibrativo 1 de Nucleosídeo/genética , Regulação Neoplásica da Expressão Gênica , Proteína de Leucina Linfoide-Mieloide/efeitos dos fármacos , Neoplasia Residual , Leucemia-Linfoma Linfoblástico de Células Precursoras , Reação em Cadeia da Polimerase/métodos , RNA Mensageiro/análise , Fatores de Tempo

RESUMO

The records and biopsies of 10 patients with the diagnosis of leiomyosarcomas admitted at the Military Hospital "Dr. Carlos Arvelo" from 1962 to 1991, were reviewed. The sample correspond to 0.47% of all gastro-intestinal tumors. Sixty per cent of tumors were localized in the stomach, 20% in the jejunum, 10% in the duodenum and 10% in the colon. Eighty per cent had pain and 60% had bleeding. Sixty per cent of tumors were low grade leiomyosarcomas and 40% were epithelioid leiomyosarcomas. In eight of nine patients operated, resection was done. The survival range was from six months to 28 years with a median of 12 years. The most important prognostic factor was the extension of the tumor, independently of he histologic type.

Assuntos

Neoplasias Gastrointestinais/patologia , Leiomiossarcoma/patologia , Adulto , Fatores Etários , Idoso , Feminino , Neoplasias Gastrointestinais/mortalidade , Neoplasias Gastrointestinais/cirurgia , Humanos , Leiomiossarcoma/mortalidade , Leiomiossarcoma/cirurgia , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores Sexuais , Taxa de Sobrevida

RESUMO

We present a 15-years-old female patient severely malnourished due to complications of abdominal surgery, who received total parenteral nutrition during 118 days. The clinical and laboratory parameters are analyzed and a photographic sequence is presented. During the treatment period nitrogen balance was positive and her weight increased in 50%.

Assuntos

Distúrbios Nutricionais/terapia , Nutrição Parenteral Total , Complicações Pós-Operatórias/terapia , Procedimentos Cirúrgicos Operatórios , Doença Aguda , Adolescente , Terapia Combinada , Feminino , Humanos , Distúrbios Nutricionais/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Fatores de Tempo