JULIANA PEREIRA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
LIM/31 - Laboratório de Genética e Hematologia Molecular, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/31 - Laboratório de Genética e Hematologia Molecular, Hospital das Clínicas, Faculdade de Medicina - Líder
41 resultados
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Agora exibindo 1 - 10 de 41
- Analysis of clonal immunoglobulin chain gene rearrangement by the technique of polymerase chain reaction (PCR) to aid in the diagnosis of B-cell cutaneous lymphoproliferative processes(2023) GUIMARAES, Adriana Borba; SANCHES JUNIOR, Jose Antonio; ZERBINI, Maria Claudia; MIYASHIRO, Denis Ricardo; CURY-MARTINS, Jade; PEREIRA, Juliana; CULLER, Hebert Fabricio; CASTRO, Bruno
- Chronic activation profile of circulating CD8+T cells in Sezary syndrome(2018) TORREALBA, Marina Passos; MANFRERE, Kelly Cristina; MIYASHIRO, Denis R.; LIMA, Josenilson F.; OLIVEIRA, Luana de M.; PEREIRA, Natalli Z.; CURY-MARTINS, Jade; PEREIRA, Juliana; DUARTE, Alberto J. S.; SATO, Maria N.; SANCHES, Jose A.Sezary syndrome (SS) is a leukemic variant of cutaneous T cell lymphoma (CTCL), and the neoplastic CD4+ T cells of SS patients undergo intense clonal proliferation. Although Sezary cells have been studied extensively, studies on adaptive immunity regarding CD8+ T cells are scarce. This study aimed to investigate activation marker expression in CD8+ T cells according to the differentiation stages and IL-7/IL7Ra axis responses of patients with SS. Moreover, this study aimed to verify the soluble forms of CD38, sCD127 and IL-7 in serum. Although the SS patients of our cohort had reduced numbers of CD8+ T cells, they exhibited higher percentages of CD8+CD38+T cells, mainly effector/memory CD8+ T cells, than the control group. In contrast, down-regulated expression of the activation markers CD127/IL-7R and CD26 was found in the CD8+ T cells of SS patients. High serum levels of sCD38 and sCD127 and scarce serum levels of IL-7 were detected, emphasizing the immune activation status of SS patients. Moreover, CD8+ T cells from SS patients exhibited IL-7 unresponsiveness to STAT5 phosphorylation and Bcl-2 expression, and IL-7 priming partially restored IFN gamma production. Our findings showed a chronic activation profile of CD8+ T cells, as an attenuated cytotoxic profile and impaired IL-7 responsiveness was observed, suggesting chronic activation status of CD8+ T cells in SS patients.
- Less Intensive Regimens May Still Be Suitable for the Initial Treatment of Primary Mediastinal B-Cell Lymphoma in Resource-Limited Settings(2022) VELASQUES, Rodrigo Dolphini; SILVA, Wellington F. da; BELLESSO, Marcelo; ROCHA, Vanderson; PEREIRA, JulianaPrimary mediastinal B-cell lymphoma (PMBCL) is an uncommon disease, consisting of 2-4% of non-Hodgkin lymphomas. Radiotherapy-free DA-EPOCH-R and R-CHOP plus radiotherapy (RT) have been the upfront standard regimens worldwide. However, performing DA-EPOCH-R in resource-constrained settings can be burdensome, especially in low/middle-income countries, where data on PMBCL are still largely unknown. We retrospectively analyzed 93 patients with PMBCL diagnosed between 2008 and 2018 with the intention of comparing the characteristics of the patients and the results obtained with each protocol and to verify if the use of less intensive chemotherapy is still possible to be used. The median age was 28 years, 59.1% were female, 42.3% were in advanced stages, and 92.1% were with bulky disease. DA-EPOCH-R (41.9%), R-CHOP (35.5%), and R-CHOEP (22.6%) were the regimens used, and no difference was observed in the characteristics of the patients. After four cycles of chemotherapy, complete response (CR), partial response (PR), and progressive disease (PD) rates were 40%, 55.7%, and 4.5%, respectively. At the end of treatment, metabolic CR and PD rates were 56.8% and 11.1%. RT was performed in 42.1% of DA-EPOCH-R, 75% of R-CHOP, and 83% of R-CHOEP, and switched PR to CR in 73.7%. Estimated 5-year PFS and OS were 77.2% and 77.4%, respectively. Only LDH levels remained independently associated with PFS, and type of treatment was not associated with OS, PFS, or relapse rate. Therefore, we conclude that in a resource-constrained setting, R-CHOP or R-CHOEP could be still safely adopted in upfront treatment for PMBCL.
conferenceObject Blastic plasmocytoid dendritic cell neoplasm: a series of fourteen cases from a reference center in Brazil(2019) CURY-MARTINS, J.; OLIVEIRA, I. F.; MIYASHIRO, D.; PEREIRA, J.; ABDO, A. N. R.; ZERBINI, M. C.; GIANNOTTI, M. A.; SANCHES, J. A.- 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, FrancoThe 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.
- Angioimmunoblastic T-cell lymphoma and correlated neoplasms with T-cell follicular helper phenotype: from molecular mechanisms to therapeutic advances(2023) LAGE, Luis Alberto de Padua Covas; CULLER, Hebert Fabricio; REICHERT, Cadiele Oliana; SIQUEIRA, Sheila Aparecida Coelho da; PEREIRA, JulianaAngioimmunoblastic T-cell lymphoma (AITL) is the second most frequent subtype of mature T-cell lymphoma (MTCL) in the Western world. It derives from the monoclonal proliferation of T-follicular helper (TFH) cells and is characterized by an exacerbated inflammatory response and immune dysregulation, with predisposition to autoimmunity phenomena and recurrent infections. Its genesis is based on a multistep integrative model, where age-related and initiator mutations involve epigenetic regulatory genes, such as TET-2 and DNMT3A. Subsequently, driver-mutations, such as RhoA G17V and IDH-2 R172K/S promote the expansion of clonal TFH-cells (""second-hit""), that finally begin to secrete cytokines and chemokines, such as IL-6, IL-21, CXCL-13 and VEGF, modulating a network of complex relationships between TFH-cells and a defective tumor microenvironment (TME), characterized by expansion of follicular dendritic cells (FDC), vessels and EBV-positive immunoblasts. This unique pathogenesis leads to peculiar clinical manifestations, generating the so-called ""immunodysplastic syndrome"", typical of AITL. Its differential diagnosis is broad, involving viral infections, collagenosis and adverse drug reactions, which led many authors to use the term ""many-faced lymphoma"" when referring to AITL. Although great advances in its biological knowledge have been obtained in the last two decades, its treatment is still an unmet medical need, with highly reserved clinical outcomes. Outside the setting of clinical trials, AITL patients are still treated with multidrug therapy based on anthracyclines (CHOP-like), followed by up-front consolidation with autologous stem cell transplantation (ASCT). In this setting, the estimated 5-year overall survival (OS) is around 30-40%. New drugs, such as hypomethylating agents (HMAs) and histone deacetylase inhibitors (HDAi), have been used for relapsed/refractory (R/R) disease with promising results. Such agents have their use based on a biological rationale, have significant potential to improve the outcomes of patients with AITL and may represent a paradigm shift in the therapeutic approach to this lymphoma in the near future.
- 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.
conferenceObject Peripheral T cell lymphoma, not otherwise specified involving the skin: is it always aggressive?(2019) CURY-MARTINS, J.; SANCHES, J. A.; CARVALHO, C. H. C.; MIYASHIRO, D.; LAGE, L. A. P. C.; ZERBINI, M. C.; GIANNOTTI, M. A.; PEREIRA, J.- 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
- A prospective, multicenter, randomized study of anti-CCR4 monoclonal antibody mogamulizumab (moga) vs investigator's choice (IC) in the treatment of patients (pts) with relapsed/refractory (R/R) adult T-cell leukemia-lymphoma (ATL)(2016) PHILLIPS, Adrienne Alise; FIELDS, Paul; HERMINE, Olivier; RAMOS, Juan Carlos; BELTRAN, Brady Ernesto; PEREIRA, Juliana; BRITES, Carlos; KURMAN, Michael R.; GEORGE, Joyce; DWYER, Karen M.; CONLON, Kevin; TAYLOR, Graham P.; GONSKY, Jason Parker; HORWITZ, Steven M.