JULIANA PEREIRA

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Departamento de Clínica Médica, Faculdade de Medicina - Docente
LIM/31 - Laboratório de Genética e Hematologia Molecular, Hospital das Clínicas, Faculdade de Medicina - Líder

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  • article 0 Citação(ões) na Scopus
    Respiratory viruses and postoperative hemodynamics in patients with unrestrictive congenital cardiac communications: a prospective cohort study
    (2023) ABUD, Kelly C. O.; MACHADO, Clarisse M.; BOAS, Lucy S. Vilas S.; MAEDA, Nair Y.; CARVALHO, Eloisa S.; SOUZA, Maria Francilene S.; GAIOLLA, Paula V.; CASTRO, Claudia R. P.; PEREIRA, Juliana; RABINOVITCH, Marlene; LOPES, Antonio Augusto
    BackgroundPulmonary vascular abnormalities pose a risk for severe life-threatening hemodynamic disturbances following surgical repair of congenital cardiac communications (CCCs). In the distal lung, small airways and vessels share a common microenvironment, where biological crosstalks take place. Because respiratory cells infected by viruses express a number of molecules with potential impact on airway and vascular remodeling, we decided to test the hypothesis that CCC patients carrying viral genomes in the airways might be at a higher risk for pulmonary (and systemic) hemodynamic disturbances postoperatively.MethodsSixty patients were prospectively enrolled (age 11 [7-16] months, median with interquartile range). Preoperative pulmonary/systemic mean arterial pressure ratio (PAP/SAP) was 0.78 (0.63-0.88). The presence or absence of genetic material for respiratory viruses in nasopharyngeal and tracheal aspirates was investigated preoperatively in the absence of respiratory symptoms using real-time polymerase chain reaction (kit for detection of 19 pathogens). Post-cardiopulmonary bypass (CPB) inflammatory reaction was analyzed by measuring serum levels of 36 inflammatory proteins (immunoblotting) 4 h after its termination. Postoperative hemodynamics was assessed using continuous recording of PAP and SAP with calculation of PAP/SAP ratio.ResultsViral genomes were detected in nasopharynx and the trachea in 64% and 38% of patients, respectively. Rhinovirus was the most prevalent agent. The presence of viral genomes in the trachea was associated with an upward shift of postoperative PAP curve (p = 0.011) with a PAP/SAP of 0.44 (0.36-0.50) in patients who were positive versus 0.34 (0.30-0.45) in those who were negative (p = 0.008). The presence or absence of viral genomes in nasopharynx did not help predict postoperative hemodynamics. Postoperative PAP/SAP was positively correlated with post-CPB levels of interleukin-1 receptor antagonist (p = 0.026), macrophage migration inhibitory factor (p = 0.019) and monocyte chemoattractant protein-1 (p = 0.031), particularly in patients with virus-positive tracheal aspirates.ConclusionsPatients with CCCs carrying respiratory viral genomes in lower airways are at a higher risk for postoperative pulmonary hypertension, thus deserving special attention and care. Preoperative exposure to respiratory viruses and post-CPB inflammatory reaction seem to play a combined role in determining the postoperative behavior of the pulmonary circulation.
  • article 11 Citação(ões) na Scopus
    Association between bortezomib dose intensity and overall survival in mantle cell lymphoma patients on frontline VR-CAP in the phase 3 LYM-3002 study(*)
    (2019) ROBAK, Tadeusz; HUANG, Huiqiang; JIN, Jie; ZHU, Jun; LIU, Ting; SAMOILOVA, Olga; PYLYPENKO, Halyna; VERHOEF, Gregor; SIRITANARATKUL, Noppadol; OSMANOV, Evgenii; PEREIRA, Juliana; MAYER, Jiri; HONG, Xiaonan; OKAMOTO, Rumiko; PEI, Lixia; ROONEY, Brendan; VELDE, Helgi van de; CAVALLI, Franco
    The pivotal LYM-3002 study compared frontline rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) with bortezomib, rituximab, cyclophosphamide, doxorubicin and prednisone (VR-CAP) in newly diagnosed mantle cell lymphoma (MCL) patients for whom stem cell transplantation was not an option. This post hoc subanalysis of the VR-CAP data from LYM-3002 evaluated the effect of bortezomib dose intensity on OS in patients who completed >= 6 cycles of treatment. From the end of cycle 6, patients receiving >= 4.6 mg/m(2)/cycle of bortezomib had significantly longer OS (but not PFS) compared with those receiving <4.6 mg/m(2)/cycle by univariate analysis (HR 0.43 [95% CI: 0.23-0.80]; p = .0059). This association remained significant in multivariate analysis adjusting for baseline patient and disease characteristics (HR 0.40 [95% CI: 0.20-0.79]; p = .008]. Higher bortezomib dose intensity was the strongest predictor of OS in newly diagnosed MCL patients receiving VR-CAP. Clinicaltrials.gov identifier: NCT00722137.
  • article 5 Citação(ões) na Scopus
    Cardiac Tamponade as the First Manifestation of Erdheim-Chester Disease
    (2020) COSTA, Isabela B. S. da S.; COSTA, Fernanda A. de S.; BITTAR, Cristina S.; RIZK, Stephanie I.; ABDO, Andre N. R.; SIQUEIRA, Sheila A. C.; ROCHA, Vanderson; PEREIRA, Juliana; KY, Bonnie; HAJJAR, Ludhmila A.
  • article 0 Citação(ões) na Scopus
    Maximum-tolerated dose of lomustine used in combination with etoposide and cyclophosphamide in conditioning regimen for hematopoietic stem cell transplantation in lymphoma patients
    (2022) LEAL, Christianne Toledo de Souza; COSTA, Luciano Jose Megale; PEREIRA, Juliana; DUARTE, Fernando Barroso; TAVARES, Raphael Barros; ATALLA, Angelo; SABIONI, Bruna Sousa; NETO, Abrahao Elias Hallack
  • article 317 Citação(ões) na Scopus
    Bortezomib-Based Therapy for Newly Diagnosed Mantle-Cell Lymphoma
    (2015) ROBAK, Tadeusz; HUANG, Huiqiang; JIN, Jie; ZHU, Jun; LIU, Ting; SAMOILOVA, Olga; PYLYPENKO, Halyna; VERHOEF, Gregor; SIRITANARATKUL, Noppadol; OSMANOV, Evgenii; ALEXEEVA, Julia; PEREIRA, Juliana; DRACH, Johannes; MAYER, Jiri; HONG, Xiaonan; OKAMOTO, Rumiko; PEI, Lixia; ROONEY, Brendan; VELDE, Helgi van de; CAVALLI, Franco
    BACKGROUND The proteasome inhibitor bortezomib was initially approved for the treatment of relapsed mantle-cell lymphoma. We investigated whether substituting bortezomib for vincristine in frontline therapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) could improve outcomes in patients with newly diagnosed mantle-cell lymphoma. METHODS In this phase 3 trial, we randomly assigned 487 adults with newly diagnosed mantle-cell lymphoma who were ineligible or not considered for stem-cell transplantation to receive six to eight 21-day cycles of R-CHOP intravenously on day 1 (with prednisone administered orally on days 1 to 5) or VR-CAP (R-CHOP regimen, but replacing vincristine with bortezomib at a dose of 1.3 mg per square meter of body-surface area on days 1, 4, 8, and 11). The primary end point was progression-free survival. RESULTS After a median follow-up of 40 months, median progression-free survival (according to independent radiologic review) was 14.4 months in the R-CHOP group versus 24.7 months in the VR-CAP group (hazard ratio favoring the VR-CAP group, 0.63; P<0.001), a relative improvement of 59%. On the basis of investigator assessment, the median durations of progression-free survival were 16.1 months and 30.7 months, respectively (hazard ratio, 0.51; P<0.001), a relative improvement of 96%. Secondary end points were consistently improved in the VR-CAP group, including the complete response rate (42% vs. 53%), the median duration of complete response (18.0 months vs. 42.1 months), the median treatment-free interval (20.5 months vs. 40.6 months), and the 4-year overall survival rate (54% vs. 64%). Rates of neutropenia and thrombocytopenia were higher in the VR-CAP group. CONCLUSIONS VR-CAP was more effective than R-CHOP in patients with newly diagnosed mantle-cell lymphoma but at the cost of increased hematologic toxicity. (Funded by Janssen Research and Development and Millennium Pharmaceuticals; LYM-3002 ClinicalTrials.gov number, NCT00722137.)
  • article 50 Citação(ões) na Scopus
    Mogamulizumab versus investigator's choice of chemotherapy regimen in relapsed/refractory adult T-cell leukemia/lymphoma
    (2019) PHILLIPS, Adrienne A.; FIELDS, Paul A.; HERMINE, Olivier; RAMOS, Juan C.; BELTRAN, Brady E.; PEREIRA, Juliana; WANDROO, Farooq; FELDMAN, Tatyana; TAYLOR, Graham P.; SAWAS, Ahmed; HUMPHREY, Jeffrey; KURMAN, Michael; MORIYA, Junji; DWYER, Karen; LEONI, Mollie; CONLON, Kevin; COOK, Lucy; GONSKY, Jason; HORWITZ, Steven M.
    Mogamulizumab, a humanized defucosylated anti-C-C chemokine receptor 4 monoclonal antibody, has been approved in Japan for the treatment of C-C chemokine receptor 4-positive adult T-cell leukemia/lymphoma (ATL). This phase II study evaluated efficacy and safety of mogamulizumab in ATL patients with acute, lymphoma, and chronic subtypes with relapsed/refractory, aggressive disease in the US, Europe, and Latin America. With stratification by subtype, patients were randomized 2: 1 to intravenous mogamulizumab 1.0 mg/kg once weekly for 4 weeks and biweekly thereafter (n=47) or investigator's choice of chemotherapy (n=24). The primary end point was confirmed overall response rate (cORR) confirmed on a subsequent assessment at 8 weeks by blinded independent review. ORR was 11% (95% CI: 4-23%) and 0% (95% CI: 0-14%) in the mogamulizumab and chemotherapy arms, respectively. Best response was 28% and 8% in the respective arms. The observed hazard ratio for progression-free survival was 0.71 (95% CI: 0.41-1.21) and, after post hoc adjustment for performance status imbalance, 0.57 (95% CI: 0.337-0.983). The most frequent treatment-related adverse (grade >= 3) events with mogamulizumab were infusion-related reaction and thrombocytopenia (each 9%). Relapsed/refractory ATL is an aggressive, poor prognosis disease with a high unmet need. Investigator's choice chemotherapy did not result in tumor response in this trial; however, mogamulizumab treatment resulted in 11% cORR, with a tolerable safety profile.
  • article 11 Citação(ões) na Scopus
    Radiographic patterns of multiple myeloma in the jawbones of patients treated with intravenous bisphosphonates
    (2018) FARIA, Karina Morais; RIBEIRO, Ana Carolina Prado; BRANDAO, Thais Bianca; SILVA, Wagner Gomes; LOPES, Marcio Ajudarte; PEREIRA, Juliana; ALVES, Marcelo Correa; GUEIROS, Luiz Alcino; SHINTAKU, Werner Harumiti; MIGLIORATI, Cesar Augusto; SANTOS-SILVA, Alan Roger
    Background. The purpose of this study was to evaluate whether intravenous (IV) bisphosphonate (BP) therapy can change the radiographic patterns of multiple myeloma (MM) in the jawbones. Methods. The authors evaluated panoramic radiographs obtained from 188 patients with MM for the presence of solitary osteolytic lesions, multiple osteolytic lesions, diffuse osteoporosis, diffuse sclerosis, lamina dura abnormalities, nonhealing alveolar sockets, and bone sequestration. The authors compared results obtained from patients treated with IV BPs with those obtained from patients who had never been exposed to BPs. Results. Multiple osteolytic lesions (P = .001), diffuse osteoporosis (P = .001), and diffuse sclerosis (P = .0036) occurred more often in the mandible in both groups. Solitary osteolytic lesions occurred less frequently in the BP group (P = .0078). Lamina dura abnormalities (P = .0006) and nonhealing alveolar sockets (P = .0021) were associated with BP treatment. Conclusions. IV BP therapy changes the radiographic patterns of MM in the jawbones. Practical Implications. The effect of BPs in the maxillofacial area is a matter of concern for health practitioners because this type of medication causes several alterations of the jawbones in patients with cancer.
  • article 94 Citação(ões) na Scopus
    Randomized Phase III Study of Alisertib or Investigator's Choice (Selected Single Agent) in Patients With Relapsed or Refractory Peripheral T-Cell Lymphoma
    (2019) O'CONNOR, Owen A.; OZCAN, Muhit; JACOBSEN, Eric D.; RONCERO, Josep M.; TROTMAN, Judith; DEMETER, Judit; MASSZI, Tamas; PEREIRA, Juliana; RAMCHANDREN, Radhakrishnan; BEAVEN, Anne; CABALLERO, Dolores; HORWITZ, Steven M.; LENNARD, Anne; TURGUT, Mehmet; HAMERSCHLAK, Nelson; D'AMORE, Francesco A.; FOSS, Francine; KIM, Won-Seog; LEONARD, John P.; ZINZANI, Pier Luigi; CHIATTONE, Carlos S.; HSI, Eric D.; TRUEMPER, Lorenz; LIU, Hua; SHELDON-WANIGA, Emily; ULLMANN, Claudio Dansky; VENKATAKRISHNAN, Karthik; LEONARD, E. Jane; SHUSTOV, Andrei R.
    PURPOSEThe aim of this open-label, first-in-setting, randomized phase III trial was to evaluate the efficacy of alisertib, an investigational Aurora A kinase inhibitor, in patients with relapsed/refractory peripheral T-cell lymphoma (PTCL).PATIENTS AND METHODSAdult patients with relapsed/refractory PTCLone or more prior therapywere randomly assigned 1:1 to receive oral alisertib 50 mg two times per day (days 1 to 7; 21-day cycle) or investigator-selected single-agent comparator, including intravenous pralatrexate 30 mg/m(2) (once per week for 6 weeks; 7-week cycle), or intravenous gemcitabine 1,000 mg/m(2) or intravenous romidepsin 14 mg/m(2) (days 1, 8, and 15; 28-day cycle). Tumor tissue (disease subtype) and imaging were assessed by independent central review. Primary outcomes were overall response rate and progression-free survival (PFS). Two interim analyses and one final analysis were planned.RESULTSBetween May 2012 and October 2014, 271 patients were randomly assigned (alisertib, n = 138; comparator, n = 133). Enrollment was stopped early on the recommendation of the independent data monitoring committee as a result of the low probability of alisertib achieving PFS superiority with full enrollment. Centrally assessed overall response rate was 33% for alisertib and 45% for the comparator arm (odds ratio, 0.60; 95% CI, 0.33 to 1.08). Median PFS was 115 days for alisertib and 104 days for the comparator arm (hazard ratio, 0.87; 95% CI, 0.637 to 1.178). The most common adverse events were anemia (53% of alisertib-treated patients v 34% of comparator-treated patients) and neutropenia (47% v 31%, respectively). A lower percentage of patients who received alisertib (9%) compared with the comparator (14%) experienced events that led to study drug discontinuation. Of 26 on-study deaths, five were considered treatment related (alisertib, n = 3 of 11; comparator, n = 2 of 15). Two-year overall survival was 35% for each arm.CONCLUSIONIn patients with relapsed/refractory PTCL, alisertib was not statistically significantly superior to the comparator arm.
  • article 64 Citação(ões) na Scopus
    Rituximab biosimilar and reference rituximab in patients with previously untreated advanced follicular lymphoma (ASSIST-FL): primary results from a confirmatory phase 3, double-blind, randomised, controlled study
    (2017) JURCZAK, Wojciech; MOREIRA, Ilidia; KANAKASETTY, Govind Babu; MUNHOZ, Eduardo; ECHEVESTE, Maria Asuncion; GIRI, Pratyush; CASTRO, Nelson; PEREIRA, Juliana; AKRIA, Luiza; ALEXEEV, Sergey; OSMANOV, Eugeniy; ZHU, Peijuan; ALEXANDROVA, Siyka; ZUBEL, Angela; HARLIN, Olof; AMERSDORFFER, Jutta
    Background GP2013 is a rituximab biosimilar developed to stringent development guidelines, including non-clinical and preclinical investigations and clinical trials in rheumatoid arthritis and follicular lymphoma. We aimed to compare the efficacy, safety, tolerability, pharmacokinetics, and pharmacodynamics of GP2013 plus cyclophosphamide, vincristine, and prednisone (GP2013-CVP) with rituximab-CVP (R-CVP) in patients with follicular lymphoma. Methods In this phase 3, multinational, double-blind, randomised, controlled trial, adults (aged 18 years or older) with previously untreated, advanced stage (Ann Arbor stage III or IV) follicular lymphoma of WHO histological grades 1, 2, or 3a were randomly assigned (1: 1) using interactive response technology to eight cycles of GP2013-CVP or R-CVP (combination phase), followed by monotherapy maintenance in responders for a 2-year period Randomisation was stratified by Follicular Lymphoma International Prognostic Index risk group and geographic region. The primary endpoint was comparability in overall response, with equivalence concluded if the entire 95% CI was within a margin of -12% to 12%. The primary endpoint was analysed using the per-protocol set, which included all patients who received at least one (partial or complete) dose of investigational treatment and who did not have any major protocol deviations. The trial is registered with ClinicalTrials. gov, number NCT01419665, and is ongoing. Findings Between Dec 1, 2011, and Jan 15, 2015, 858 patients were screened for eligibility. 314 patients were randomly assigned to GP2013, of whom 312 were given GP2013, and 315 were assigned to reference rituximab. Median followup was 11 center dot 6 months (IQR 5 center dot 8-18 center dot 2) for the primary analysis. The primary endpoint, equivalence of overall response, was met (271 [87%] of 311 patients with GP2013 and 274 [88%] of 313 patients with reference rituximab achieved an overall response; difference -0 center dot 40% [95% CI -5 center dot 94 to 5 center dot 14]). Occurrence of adverse events and serious adverse events was similar between the treatment groups (289 [93%] of 312 patients in the GP2013-CVP group had an adverse event and 71 [23%] of 312 patients had a serious adverse event; 288 [91%] of 315 patients in the R-CVP group had an adverse event and 63 [20%] had a serious adverse event). The most common adverse event was neutropenia (80 [26%] of 312 patients in the GP2013-CVP group and 93 [30%] of 315 patients in the R-CVP group in the combination phase and 23 [10%] of 231 patients in the GP2013-CVP group and 13 [6%] of 231 patients in the R-CVP group in the maintenance phase). The most common grade 3 or 4 adverse event during the combination and maintenance phase was neutropenia (55 [18%] of 312 patients in the GP2013-CVP group and 65 [21%] of 315 patients in the R-CVP group in the combination phase and 17 [7%] of 231 patients in the GP2013-CVP group and nine [4%] of 231 patients in the R-CVP group in the maintenance phase). The occurrence of anti-drug antibodies was similar in the treatment groups (five [2%] of 268 patients in the GP2013-CVP; three [1%] in the R-CVP group). Interpretation Our results show that GP2013 represents a viable rituximab biosimilar candidate for patients with previously untreated advanced follicular lymphoma. The introduction of biosimilars provides additional therapeutic options with potential to increase access to effective and life-saving biological therapies such as rituximab.
  • conferenceObject
    Final overall survival results of frontline bortezomib plus rituximab, cyclophosphamide, doxorubicin, and prednisone (VR-CAP) vs R-CHOP in transplantation-ineligible patients (pts) with newly diagnosed mantle-cell lymphoma (MCL): A randomized, open-label, phase III (LYM-3002) study
    (2018) CAVALLI, F.; JIN, J.; PYLYPENKO, H.; VERHOEF, G.; SIRITANARATKUL, N.; DRACH, J.; RADERER, M.; MAYER, J.; PEREIRA, J.; TUMYAN, G.; OKAMOTO, R.; NAKAHARA, S.; HU, P.; APPIANI, C.; NEMAT, S.; ROBAK, T.